Transit Operations Decision Support System (TODSS) core requirements evaluation and update recommendations.

DOT National Transportation Integrated Search

2009-10-01

Transit Operations Decision Support Systems (TODSS) are systems designed to support dispatchers and others in real-time operations : management in response to incidents, special events, and other changing conditions in order to improve operating spee...

Evaluation Brief: Implementation and Outcomes of Kansas Multi-Tier System of Supports: 2011-2014

ERIC Educational Resources Information Center

Reedy, Kristen; Lacireno-Paquet, Natalie

2015-01-01

States, school districts, and schools across the country are increasingly implementing multi-tier systems of support (MTSS) to improve outcomes for all students. Kansas is no exception. The Kansas MTSS is designed to improve outcomes for all students by instituting system-level change across the classroom, school, district, and state. Such…

Front-Line Physicians' Satisfaction with Information Systems in Hospitals.

PubMed

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

PubMed Central

Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

PubMed

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

Leveraging finances for public health system improvement: results from the Turning Point initiative.

PubMed

Bekemeier, Betty; Riley, Catharine M; Berkowitz, Bobbie

2007-01-01

Reforming the public health infrastructure requires substantial system changes at the state level; state health agencies, however, often lack the resources and support for strategic planning and systemwide improvement. The Turning Point Initiative provided support for states to focus on large-scale system changes that resulted in increased funding for public health capacity and infrastructure development. Turning Point provides a test case for obtaining financial and institutional resources focused on systems change and infrastructure development-areas for which it has been historically difficult to obtain long-term support. The purpose of this exploratory, descriptive survey research was to enumerate the actual resources leveraged toward public health system improvement through the partnerships, planning, and implementation activities funded by the Robert Wood Johnson Foundation as a part of the Turning Point Initiative.

The Relationship between Emotional and Esteem Social Support Messages and Health.

PubMed

Robinson, James D; Turner, Jeanine W; Tian, Yan; Neustadtl, Alan; Mun, Seong Ki; Levine, Betty

2017-11-28

The purpose of this investigation is to determine the relative contribution of five types of social support to improved patient health. This analysis suggests that emotional and esteem social support messages are associated with improved patient health as measured by a decrease in average blood glucose levels among diabetic patients. In addition, when two system feature variables, two system use variables, two measures of learning, one measure of self-efficacy, and one measure of affect toward their HCP were added to the baseline model, a third significant factor emerged. Perceptions about learning about diabetes from reading the digital messages sent by their HCP also predicted improved patient health. Cognitive-Emotional Theory of Esteem Support Messages suggests a combination of esteem social support and emotional social support messages enhanced our ability to predict improved patient health by change in patient hemoglobin A1c (HbA1c) scores. While a nonrandomized prospective study, this investigation provides support for the notion that provider-patient interaction is related to improved patient health and that both emotional and esteem social support messages play a role in that process. Finally, the study suggests some types of social support are and other types are not associated with improved patient health; this is consistent with the optimal matching hypothesis.

Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration

PubMed Central

Hynes, Denise M.; Perrin, Ruth A.; Rappaport, Steven; Stevens, Joanne M.; Demakis, John G.

2004-01-01

Information systems are increasingly important for measuring and improving health care quality. A number of integrated health care delivery systems use advanced information systems and integrated decision support to carry out quality assurance activities, but none as large as the Veterans Health Administration (VHA). The VHA's Quality Enhancement Research Initiative (QUERI) is a large-scale, multidisciplinary quality improvement initiative designed to ensure excellence in all areas where VHA provides health care services, including inpatient, outpatient, and long-term care settings. In this paper, we describe the role of information systems in the VHA QUERI process, highlight the major information systems critical to this quality improvement process, and discuss issues associated with the use of these systems. PMID:15187063

Staff Preparation, Reward, and Support: Are Quality Rating and Improvement Systems Addressing All of the Key Ingredients Necessary for Change? Policy Report

ERIC Educational Resources Information Center

Austin, Lea J. E.; Whitebook, Marcy; Connors, Maia; Darrah, Rory

2011-01-01

Reflecting the growing momentum in support of quality rating and improvement systems (QRISs) as a key strategy to improve early care and education quality, significant amounts of public dollars have been devoted to their development and implementation. In this brief, the authors report on their investigation of both quality rating and improvement…

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

Analysis of alternatives for using cable bolts as primary support at two low-seam coal mines

PubMed Central

Esterhuizen, Gabriel S.; Tulu, Ihsan B.

2016-01-01

Cable bolts are sometimes used in low-seam coal mines to provide support in difficult ground conditions. This paper describes cable bolting solutions at two low-seam coal mines in similar ground conditions. Both mines used support systems incorporating cable bolts as part of the primary support system. Two original cable bolt based support systems as well as two modified systems are evaluated to estimate their ability to prevent large roof falls. One of the support systems incorporated passive cable bolts, while the other used pre-tensioned cable bolts. The results and experience at the mines showed that the modified systems provided improved stability over the original support systems. The presence of the cable bolts is the most important contribution to stability against large roof falls, rather than the details of the support pattern. It was also found that a heavy steel channel can improve the safety of the system because of the ‘sling’ action it provides. Additionally, the analysis showed that fully-grouted rebar bolts load much earlier than the cable bolts, and pre-tensioning of the cable bolts can result in a more uniform distribution of loading in the roof. PMID:27722019

Meteorological support for space operations: Review and recommendations

NASA Technical Reports Server (NTRS)

1988-01-01

The current meteorological support provided to NASA by NOAA, Air Weather Service, and other contractors is reviewed and suggestions are offered for its improvement. These recommendations include improvement in NASA's internal management organizational structure that would accommodate continued improvement in operational weather support, installation of new observing systems, improvement in analysis and forecasting procedures, and the establishment of an Applied Research and Forecasting Facility.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

PubMed Central

Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

2010-01-01

Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

A computerized clinical decision support system as a means of implementing depression guidelines.

PubMed

Trivedi, Madhukar H; Kern, Janet K; Grannemann, Bruce D; Altshuler, Kenneth Z; Sunderajan, Prabha

2004-08-01

The authors describe the history and current use of computerized systems for implementing treatment guidelines in general medicine as well as the development, testing, and early use of a computerized decision support system for depression treatment among "real-world" clinical settings in Texas. In 1999 health care experts from Europe and the United States met to confront the well-documented challenges of implementing treatment guidelines and to identify strategies for improvement. They suggested the integration of guidelines into computer systems that is incorporated into clinical workflow. Several studies have demonstrated improvements in physicians' adherence to guidelines when such guidelines are provided in a computerized format. Although computerized decision support systems are being used in many areas of medicine and have demonstrated improved patient outcomes, their use in psychiatric illness is limited. The authors designed and developed a computerized decision support system for the treatment of major depressive disorder by using evidence-based guidelines, transferring the knowledge gained from the Texas Medication Algorithm Project (TMAP). This computerized decision support system (CompTMAP) provides support in diagnosis, treatment, follow-up, and preventive care and can be incorporated into the clinical setting. CompTMAP has gone through extensive testing to ensure accuracy and reliability. Physician surveys have indicated a positive response to CompTMAP, although the sample was insufficient for statistical testing. CompTMAP is part of a new era of comprehensive computerized decision support systems that take advantage of advances in automation and provide more complete clinical support to physicians in clinical practice.

Product Definition Data (PDD) Current Environment Report

DOT National Transportation Integrated Search

1989-05-01

The objective of the Air Force Computer-aided Acquisition and Logistics Support (CALS) Program is to improve weapon system reliability, supportability and maintainability, and to reduce the cost of weapon system acquisition and logistics support. As ...

MOOSE IPL Extensions (Control Logic)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Permann, Cody

In FY-2015, the development of MOOSE was driven by the needs of the NEAMS MOOSE-based applications, BISON, MARMOT, and RELAP-7. An emphasis was placed on the continued upkeep and improvement MOOSE in support of the product line integration goals. New unified documentation tools have been developed, several improvements to regression testing have been enforced and overall better software quality practices have been implemented. In addition the Multiapps and Transfers systems have seen significant refactoring and robustness improvements, as has the “Restart and Recover” system in support of Multiapp simulations. Finally, a completely new “Control Logic” system has been engineered tomore » replace the prototype system currently in use in the RELAP-7 code. The development of this system continues and is expected to handle existing needs as well as support future enhancements.« less

Process Improvement Should Link to Security: SEPG 2007 Security Track Recap

DTIC Science & Technology

2007-09-01

the Systems Security Engineering Capability Maturity Model (SSE- CMM / ISO 21827) and its use in system software developments ...software development life cycle ( SDLC )? 6. In what ways should process improvement support security in the SDLC ? 1.2 10BPANEL RESOURCES For each... project management, and support practices through the use of the capability maturity models including the CMMI and the Systems Security

Supporting Parents through Parent Education. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Zepeda, Marlene; Morales, Alex

California's Proposition 10, the "Children and Families Act," has targeted three general areas for improvement in support of families and young children: improved family functioning, improved child development, and improved child health. Proposition 10 views parents as critical to the development of young children. Noting that parent…

Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

PubMed

Wandersman, Abraham; Chien, Victoria H; Katz, Jason

2012-12-01

An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

Using School Improvement and Implementation Science to Integrate Multi-Tiered Systems of Support in Secondary Schools

ERIC Educational Resources Information Center

Bohanon, Hank; Gilman, Carrie; Parker, Ben; Amell, Chris

2016-01-01

The purpose of this paper is to describe the integration of tiered interventions and supports in secondary schools, sometimes referred to as multi-tiered systems of support (MTSS). The interventions include academic, behavioural, social, and emotional supports for all students. A description of the connections across specifc MTSS systems,…

A Data Analytical Framework for Improving Real-Time, Decision Support Systems in Healthcare

ERIC Educational Resources Information Center

Yahav, Inbal

2010-01-01

In this dissertation we develop a framework that combines data mining, statistics and operations research methods for improving real-time decision support systems in healthcare. Our approach consists of three main concepts: data gathering and preprocessing, modeling, and deployment. We introduce the notion of offline and semi-offline modeling to…

RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

NASA Astrophysics Data System (ADS)

Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

2008-08-01

RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

PLANiTS : structuring and supporting the intelligent transportation systems planning process

DOT National Transportation Integrated Search

1997-01-01

PLANiTS (Planning and Analysis Integration for Intelligent Transportation Systems) is a process-based computer system that supports a series of mutually interdependent steps progressing toward developing and programming transportation improvement pro...

Improving Childhood Obesity Treatment Using New Technologies: The ETIOBE System

PubMed Central

Baños, Rosa. M; Cebolla, Ausias; Botella, Cristina; García-Palacios, Azucena; Oliver, Elia; Zaragoza, Irene; Alcaniz, Mariano

2011-01-01

Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an “obesogenic environment” are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control in patients, to obtain weight loss maintenance and to prevent relapse by establishing healthy lifestyle habits. ETIOBE is composed of three different applications, the Clinician Support System (CSS), the Home Support System (HSS) and the Mobile Support System (MSS). The use of new Information and Communication (ICT) technologies can help clinicians to improve the effectiveness of weight loss treatments, especially in the case of children, and to achieve designated treatment goals. PMID:21559232

A Conceptual Framework for the Electronic Performance Support Systems within IBM Lotus Notes 6 (LN6) Example

ERIC Educational Resources Information Center

Bayram, Servet

2005-01-01

The concept of Electronic Performance Support Systems (EPSS) is containing multimedia or computer based instruction components that improves human performance by providing process simplification, performance information and decision support system. EPSS has become a hot topic for organizational development, human resources, performance technology,…

The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

PubMed

Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

2013-06-01

The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

Triple Aim in Canada: developing capacity to lead to better health, care and cost

PubMed Central

Farmanova, Elina; Kirvan, Christine; Verma, Jennifer; Mukerji, Geetha; Akunov, Nurdin; Phillips, Kaye; Samis, Stephen

2016-01-01

Abstract Quality problem Many modern health systems strive for ‘Triple Aim’ (TA)—better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Initial assessment Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems. Choice of solution To support embedding TA across Canada, the Canadian Foundation for Healthcare Improvement supported enrolment of nine Canadian teams to participate in the Institute for Healthcare Improvement's TA Improvement Community. Implementation Structured support for TA design, implementation, evaluation and sustainability was addressed in a collaborative programme of webinars and action periods. Teams were coached to undertake and test small-scale improvements before attempting to scale. Evaluation A summative evaluation of the Canadian cohort was undertaken to assess site progress in building TA infrastructure across various healthcare settings. The evaluation explored the process of change, experiences and challenges and strategies for continuous QI. Lessons learned Delivering TA requires a sustained and coordinated effort supported by strong leadership and governance, continuous QI, engaged interdisciplinary teams and partnering within and beyond the healthcare sector. PMID:28423164

Triple Aim in Canada: developing capacity to lead to better health, care and cost.

PubMed

Farmanova, Elina; Kirvan, Christine; Verma, Jennifer; Mukerji, Geetha; Akunov, Nurdin; Phillips, Kaye; Samis, Stephen

2016-12-01

Many modern health systems strive for 'Triple Aim' (TA)-better health for populations, improved experience of care for patients and lower costs of the system, but note challenges in implementation. Outcomes of applying TA as a quality improvement framework (QI) have started to be realized with early lessons as to why some systems make progress while others do not. Limited evidence is available as to how organizations create the capacity and infrastructure required to design, implement, evaluate and sustain TA systems. To support embedding TA across Canada, the Canadian Foundation for Healthcare Improvement supported enrolment of nine Canadian teams to participate in the Institute for Healthcare Improvement's TA Improvement Community. Structured support for TA design, implementation, evaluation and sustainability was addressed in a collaborative programme of webinars and action periods. Teams were coached to undertake and test small-scale improvements before attempting to scale. A summative evaluation of the Canadian cohort was undertaken to assess site progress in building TA infrastructure across various healthcare settings. The evaluation explored the process of change, experiences and challenges and strategies for continuous QI. Delivering TA requires a sustained and coordinated effort supported by strong leadership and governance, continuous QI, engaged interdisciplinary teams and partnering within and beyond the healthcare sector. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Evaluate the ability of clinical decision support systems (CDSSs) to improve clinical practice.

PubMed

Ajami, Sima; Amini, Fatemeh

2013-01-01

Prevalence of new diseases, medical science promotion and increase of referring to health care centers, provide a good situation for medical errors growth. Errors can involve medicines, surgery, diagnosis, equipment, or lab reports. Medical errors can occur anywhere in the health care system: In hospitals, clinics, surgery centers, doctors' offices, nursing homes, pharmacies, and patients' homes. According to the Institute of Medicine (IOM), 98,000 people die every year from preventable medical errors. In 2010 from all referred medical error records to Iran Legal Medicine Organization, 46/5% physician and medical team members were known as delinquent. One of new technologies that can reduce medical errors is clinical decision support systems (CDSSs). This study was unsystematic-review study. The literature was searched on evaluate the "ability of clinical decision support systems to improve clinical practice" with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. For our searches, we employed the following keywords and their combinations: medical error, clinical decision support systems, Computer-Based Clinical Decision Support Systems, information technology, information system, health care quality, computer systems in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 38 of them were selected based on their relevancy. The CDSSs are computer programs, designed for help to health care careers. These systems as a knowledge-based tool could help health care manager in analyze evaluation, improvement and selection of effective solutions in clinical decisions. Therefore, it has a main role in medical errors reduction. The aim of this study was to express ability of the CDSSs to improve

Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

PubMed Central

2013-01-01

Background Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific programmatic components, supported by partnership-supported work to build in-country research capacity. Discussion Building on early successes, the work of the Rwanda PHIT Partnership approach to HSS has already seen noticeable increases in facility capacity and quality of care. The rigorous planned evaluation of the Partnership’s HSS activities will contribute to global knowledge about intervention methodology, cost, and population health impact. PMID:23819573

Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

PubMed

Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

2013-01-01

Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific programmatic components, supported by partnership-supported work to build in-country research capacity. Building on early successes, the work of the Rwanda PHIT Partnership approach to HSS has already seen noticeable increases in facility capacity and quality of care. The rigorous planned evaluation of the Partnership's HSS activities will contribute to global knowledge about intervention methodology, cost, and population health impact.

A Person-Centered, Registry-Based Learning Health System for Palliative Care: A Path to Coproducing Better Outcomes, Experience, Value, and Science

PubMed Central

Kamal, Arif H.; Kirkland, Kathryn B.; Meier, Diane E.; Nelson, Eugene C.; Pantilat, Steven Z.

2018-01-01

Abstract Background: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. Objective: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. Methods: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population. Measurements: Measurement focuses on the individual patient and family experience as the fundamental outcome of interest around which all care delivery is organized. Results: We describe an approach to codesigning and implementing a palliative care registry that functions as a learning health system, by combining patient and family inputs and clinical data to support person-centered care, quality improvement, accountability, transparency, and scientific research. Discussion: The potential for a palliative care learning health system that, by design, brings together enriched information environments to support coproduction of healthcare and facilitated peer networks to support patients and families, collaborative clinician networks to support palliative care program improvement, and collaboratories to support research and the application of research to benefit individual patients is immense. PMID:29091509

Artificial intelligence techniques for modeling database user behavior

NASA Technical Reports Server (NTRS)

Tanner, Steve; Graves, Sara J.

1990-01-01

The design and development of the adaptive modeling system is described. This system models how a user accesses a relational database management system in order to improve its performance by discovering use access patterns. In the current system, these patterns are used to improve the user interface and may be used to speed data retrieval, support query optimization and support a more flexible data representation. The system models both syntactic and semantic information about the user's access and employs both procedural and rule-based logic to manipulate the model.

Use of a wiki as a radiology departmental knowledge management system.

PubMed

Meenan, Christopher; King, Antoinette; Toland, Christopher; Daly, Mark; Nagy, Paul

2010-04-01

Information technology teams in health care are tasked with maintaining a variety of information systems with complex support requirements. In radiology, this includes picture archive and communication systems, radiology information systems, speech recognition systems, and other ancillary systems. Hospital information technology (IT) departments are required to provide 24 x 7 support for these mission-critical systems that directly support patient care in emergency and other critical care departments. The practical know-how to keep these systems operational and diagnose problems promptly is difficult to maintain around the clock. Specific details on infrequent failure modes or advanced troubleshooting strategies may reside with only a few senior staff members. Our goal was to reduce diagnosis and recovery times for issues with our mission-critical systems. We created a knowledge base for building and quickly disseminating technical expertise to our entire support staff. We used an open source, wiki-based, collaborative authoring system internally within our IT department to improve our ability to deliver a high level of service to our customers. In this paper, we describe our evaluation of the wiki and the ways in which we used it to organize our support knowledge. We found the wiki to be an effective tool for knowledge management and for improving our ability to provide mission-critical support for health care IT systems.

Building Electronic Performance Support Systems for First-Year University Students

ERIC Educational Resources Information Center

Barker, Philip; van Schaik, Paul; Famakinwa, Oladeji

2007-01-01

This paper outlines the principles and theory of performance support (in general) and of electronic performance support (in particular). It explains why the design and creation of electronic performance support systems are so important as a mechanism for providing scaffolding environments for use in improving the learning experience for new (and…

How Northwest Region States Are Supporting Schools in Need of Improvement. Issues & Answers. REL 2007-No. 009

ERIC Educational Resources Information Center

Davis, Deborah; Krasnoff, Basha; Moilanen, Carolyn; Sather, Susan; Kushman, James

2007-01-01

This study examines the systems of technical assistance and support that Northwest Region states implemented during 2005-2006 for schools in need of improvement. By highlighting key characteristics and differences among state systems, the intent is to stimulate an analysis of what states can do and what issues they might address to move schools…

Oil-Free Rotor Support Technologies for an Optimized Helicopter Propulsion System

NASA Technical Reports Server (NTRS)

DellaCorte, Christopher; Bruckner, Robert J.

2007-01-01

An optimized rotorcraft propulsion system incorporating a foil air bearing supported Oil-Free engine coupled to a high power density gearbox using high viscosity gear oil is explored. Foil air bearings have adequate load capacity and temperature capability for the highspeed gas generator shaft of a rotorcraft engine. Managing the axial loads of the power turbine shaft (low speed spool) will likely require thrust load support from the gearbox through a suitable coupling or other design. Employing specially formulated, high viscosity gear oil for the transmission can yield significant improvements (approx. 2X) in allowable gear loading. Though a completely new propulsion system design is needed to implement such a system, improved performance is possible.

Nursing informatics, outcomes, and quality improvement.

PubMed

Charters, Kathleen G

2003-08-01

Nursing informatics actively supports nursing by providing standard language systems, databases, decision support, readily accessible research results, and technology assessments. Through normalized datasets spanning an entire enterprise or other large demographic, nursing informatics tools support improvement of healthcare by answering questions about patient outcomes and quality improvement on an enterprise scale, and by providing documentation for business process definition, business process engineering, and strategic planning. Nursing informatics tools provide a way for advanced practice nurses to examine their practice and the effect of their actions on patient outcomes. Analysis of patient outcomes may lead to initiatives for quality improvement. Supported by nursing informatics tools, successful advance practice nurses leverage their quality improvement initiatives against the enterprise strategic plan to gain leadership support and resources.

Defense AR Journal, Volume 15, Number 1, April 2008

DTIC Science & Technology

2008-04-01

Beavers William Ruta DAUAA Research Paper Competition: 3rd Place Employing Organizational Modeling & Simulation of the KC-135 Depot’s Flight Controls Maj...AttAck munition SYStemS (jAmS) Project office imProvinG SuPPort to the wArfiGhter Barry Beavers and William Ruta The Joint Attack Munition Systems...William Ruta . This paper examines how the JAMS Project Office improved support to the warfighter with its implementation of the Life Cycle

Water Systems Project 1: Current Systems and Regulatory Support

EPA Science Inventory

Water Systems Project 1 objectives: 1) Supply research results to support federal regulations and guidance; 2) provide strategies to regions, states, and communities for improved regulatory compliance, and 3) provide rapid and effective emergency response where appropriate (e.g. ...

Development of prototype decision support systems for real-time freeway traffic routing. Volume I.

DOT National Transportation Integrated Search

1998-01-01

For a traffic management system (TMS) to improve traffic flow, TMS operators must develop effective routing strategies based on the data collected by the system. The purpose of this research was to build prototype decision support systems (DSS) for t...

When Informationists Get Involved: the CHICA-GIS Project.

PubMed

Whipple, Elizabeth C; Odell, Jere D; Ralston, Rick K; Liu, Gilbert C

2013-01-01

Child Health Improvement through Computer Automation (CHICA) is a computer decision support system (CDSS) that interfaces with existing electronic medical record systems (EMRS) and delivers "just-in-time" patient-relevant guidelines to physicians during the clinical encounter and accurately captures structured data from all who interact with the system. "Delivering Geospatial Intelligence to Health Care Professionals (CHICA-GIS)" (1R01LM010923-01) expands the medical application of Geographic Information Systems (GIS) by integrating a geographic information system with CHICA. To provide knowledge management support for CHICA-GIS, three informationists at the Indiana University School of Medicine were awarded a supplement from the National Library Medicine. The informationists will enhance CHICA-GIS by: improving the accuracy and accessibility of information, managing and mapping the knowledge which undergirds the CHICA-GIS decision support tool, supporting community engagement and consumer health information outreach, and facilitating the dissemination of new CHICA-GIS research results and services.

Approaches to lunar base life support

NASA Technical Reports Server (NTRS)

Brown, M. F.; Edeen, M. A.

1990-01-01

Various approaches to reliable, low maintenance, low resupply regenerative long-term life support for lunar base application are discussed. The first approach utilizes Space Station Freedom physiochemical systems technology which has closed air and water loops with approximately 99 and 90 percent closure respectively, with minor subsystem changes to the SSF baseline improving the level of water resupply for the water loop. A second approach would be a physiochemical system, including a solid waste processing system and improved air and water loop closure, which would require only food and nitrogen for resupply. A hybrid biological/physiochemical life support system constitutes the third alternative, incorporating some level of food production via plant growth into the life support system. The approaches are described in terms of mass, power, and resupply requirements; and the potential evolution of a small, initial outpost to a large, self-sustaining base is discussed.

Redox flow batteries based on supporting solutions containing chloride

DOEpatents

Li, Liyu; Kim, Soowhan; Yang, Zhenguo; Wang, Wei; Zhang, Jianlu; Chen, Baowei; Nie, Zimin; Xia, Guanguang

2014-01-14

Redox flow battery systems having a supporting solution that contains Cl.sup.- ions can exhibit improved performance and characteristics. Furthermore, a supporting solution having mixed SO.sub.4.sup.2- and Cl.sup.- ions can provide increased energy density and improved stability and solubility of one or more of the ionic species in the catholyte and/or anolyte. According to one example, a vanadium-based redox flow battery system is characterized by an anolyte having V.sup.2+ and V.sup.3+ in a supporting solution and a catholyte having V.sup.4+ and V.sup.5+ in a supporting solution. The supporting solution can contain Cl.sup.- ions or a mixture of SO.sub.4.sup.2- and Cl.sup.- ions.

Redox flow batteries based on supporting solutions containing chloride

DOEpatents

Li, Liyu; Kim, Soowhan; Yang, Zhenguo; Wang, Wei; Nie, Zimin; Chen, Baowei; Zhang, Jianlu; Xia, Guanguang

2015-07-07

Redox flow battery systems having a supporting solution that contains Cl.sup.- ions can exhibit improved performance and characteristics. Furthermore, a supporting solution having mixed SO.sub.4.sup.2- and Cl.sup.- ions can provide increased energy density and improved stability and solubility of one or more of the ionic species in the catholyte and/or anolyte. According to one example, a vanadium-based redox flow battery system is characterized by an anolyte having V.sup.2+ and V.sup.3+ in a supporting solution and a catholyte having V.sup.4+ and V.sup.5+ in a supporting solution. The supporting solution can contain Cl.sup.- ions or a mixture of SO.sub.4.sup.2- and Cl.sup.- ions.

Redox flow batteries based on supporting solutions containing chloride

DOEpatents

Li, Liyu; Kim, Soowhan; Yang, Zhenguo; Wang, Wei; Nie, Zimin; Chen, Baowei; Zhang, Jianlu; Xia, Guanguang

2015-09-01

Redox flow battery systems having a supporting solution that contains Cl.sup.- ions can exhibit improved performance and characteristics. Furthermore, a supporting solution having mixed SO.sub.4.sup.2- and Cl.sup.- ions can provide increased energy density and improved stability and solubility of one or more of the ionic species in the catholyte and/or anolyte. According to one example, a vanadium-based redox flow battery system is characterized by an anolyte having V.sup.2+ and V.sup.3+ in a supporting solution and a catholyte having V.sup.4+ and V.sup.5+ in a supporting solution. The supporting solution can contain Cl.sup.- ions or a mixture of SO.sub.4.sup.2- and Cl.sup.- ions.

Redox flow batteries based on supporting solutions containing chloride

DOEpatents

Li, Liyu; Kim, Soowhan; Yang, Zhenguo; Wang, Wei; Nie, Zimin; Chen, Baowei; Zhang, Jianlu; Xia, Guanguang

2017-11-14

Redox flow battery systems having a supporting solution that contains Cl.sup.- ions can exhibit improved performance and characteristics. Furthermore, a supporting solution having mixed SO.sub.4.sup.2- and Cl.sup.- ions can provide increased energy density and improved stability and solubility of one or more of the ionic species in the catholyte and/or anolyte. According to one example, a vanadium-based redox flow battery system is characterized by an anolyte having V.sup.2+ and V.sup.3+ in a supporting solution and a catholyte having V.sup.4+ and V.sup.5+ in a supporting solution. The supporting solution can contain Cl.sup.- ions or a mixture of SO.sub.4.sup.2- and Cl.sup.- ions.

A Systems Approach to Rapid School Improvement

ERIC Educational Resources Information Center

McCauley, Carlas

2018-01-01

To support systemic thinking about school improvement, the Center on School Turnaround at WestEd developed a framework to assist states, districts, and schools in leading and managing rapid improvement efforts. The framework, which is presented in this article, has four domains that have proved central to rapid, significant improvement: (1)…

Information Systems to Support Surveillance for Malaria Elimination

PubMed Central

Ohrt, Colin; Roberts, Kathryn W.; Sturrock, Hugh J. W.; Wegbreit, Jennifer; Lee, Bruce Y.; Gosling, Roly D.

2015-01-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. PMID:26013378

Information systems to support surveillance for malaria elimination.

PubMed

Ohrt, Colin; Roberts, Kathryn W; Sturrock, Hugh J W; Wegbreit, Jennifer; Lee, Bruce Y; Gosling, Roly D

2015-07-01

Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. © The American Society of Tropical Medicine and Hygiene.

Advanced Life Support

NASA Technical Reports Server (NTRS)

Chambliss, Joe

2004-01-01

Viewgraphs on Advanced Life Support (ALS) Systems are presented. The topics include: 1) Fundamental Need for Advanced Life Support; 2) ALS organization; 3) Requirements and Rationale; 4) Past Integrated tests; 5) The need for improvements in life support systems; 6) ALS approach to meet exploration goals; 7) ALS Projects showing promise to meet exploration goals; and 9) GRC involvement in ALS.

Computers for Command and Control: An Airland Battle Requirement!

DTIC Science & Technology

1984-05-01

systems can enhance communications, improve data management, and support decision making through information display (SEE REVERSE) JAN 173 E~lNOS~SIISLT...organizations to improve communications, enhance data management, and support decision making through graphical display techniques and mathematical...tactical commander’s control of maneuver forces. There are many reasons for the Army’s apparent inability to develop and field these systems. Among the

A computerized support system to cooperative training in emergency scenarios management and its application to an oil port domain

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balducelli, C.; Bologna, S.; Di Costanzo, G.

1995-12-31

The paper describes part of the results achieved in the framework of the MUSTER project (Multi-Users System for Training and Evaluating Environmental Emergency Response). The aim of this project is to define the detailed specifications of a computer based system supporting collaborative training for emergency management. A system prototype has been implemented to support the refinement and improvement of the system specifications.

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

MISSION: Mission and Safety Critical Support Environment. Executive overview

NASA Technical Reports Server (NTRS)

Mckay, Charles; Atkinson, Colin

1992-01-01

For mission and safety critical systems it is necessary to: improve definition, evolution and sustenance techniques; lower development and maintenance costs; support safe, timely and affordable system modifications; and support fault tolerance and survivability. The goal of the MISSION project is to lay the foundation for a new generation of integrated systems software providing a unified infrastructure for mission and safety critical applications and systems. This will involve the definition of a common, modular target architecture and a supporting infrastructure.

Integrated management of depression: improving system quality and creating effective interfaces.

PubMed

Myette, Thomas L

2008-04-01

Depression is a chronic recurrent condition and is a leading cause of work disability. Improving occupational outcomes for depression will require an integrated approach that incorporates best practices from the clinical, community, and workplace systems. This article briefly reviews recent quality improvement initiatives and promising practices in each system and then shifts to the importance of systems integration. An integrated chronic care model uses a sophisticated case management process to support essential relationships, facilitate key plans, and efficiently link the three systems to optimize clinical, economic, and occupational outcomes. An expanded role for employers and their agents in the management of depression and other chronic diseases is seen as fundamental to maintaining a healthy and productive workforce. To improve occupational outcomes for depression by integrating best practices from the clinical, community, and workplace systems. After a brief review of quality improvement initiatives and promising practices in each system, an integrated chronic care model is introduced. A case management process that links critical systems, supports essential relationships, and facilitates key plans is expected to result in improvements in clinical, economic, and occupational outcomes. Employers should be more engaged with clinical and community partners in the prevention and control of depression in affected employees.

Operational seasonal forecasting of crop performance.

PubMed

Stone, Roger C; Meinke, Holger

2005-11-29

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production.

Operational seasonal forecasting of crop performance

PubMed Central

Stone, Roger C; Meinke, Holger

2005-01-01

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production. PMID:16433097

Examining the impact of child parent relationship therapy (CPRT) on family functioning.

PubMed

Cornett, Nick; Bratton, Sue C

2014-07-01

Research supports that child parent relationship therapy (CPRT), a filial therapy approach, has strong effects on participating parents and children. Some speculate that filial therapy improves the family system; however, minimal research exists to support this claim. Using a single-case design, researchers examined CPRT's impact on the functioning of 8 families. Results revealed that 6 families experienced statistically significant improvements in targeted areas of family functioning. Results from self-reported measures indicated that 7 families improved in family satisfaction, 4 in cohesion, 3 in communication, and 1 in flexibility. Observational measures also revealed improvements: 5 families in flexibility, 4 families in cohesion, and 4 families in communication. The results support that the benefits of CPRT may extend to the family system. © 2013 American Association for Marriage and Family Therapy.

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature

PubMed Central

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems. PMID:26113945

Foreign aid or foreign investments: call for a paradigm shift in mentality and nomenclature.

PubMed

Oleribe, Obinna Ositadimma; Nwanwanyu, Okey

2015-01-01

Funding for health care programs has over the years been an important challenge for health and health care services. However with the advent of financing, part of this problem was resolved. Through these investments, lives were saved, many destinies recovered and some obsolete systems reengineered. Major proofs of these expenditures are number of people reached and sometimes number of sites opened/supported, which in several cases, are not entirely verifiable. Sustainable development from these funds is limited, and far and in between. This is despite the fact that supports for health care and health care services have been ongoing for more than 60 years. As long as these funds are seen as aids to developing countries, they will continue to fail to achieve their primary objectives. But looking at these as investments in supported countries will significantly improve the outcome, health system impacts, as well as engineer sustainable health system strengthening and improvement. Such a re-branding will reduce the politics of support, improve effectiveness and efficiency in the use of the resources, and empower receiving nations towards better health systems.

Integrated Decision Support, Sensor Networks and Adaptive Control for Wireless Site-specific Sprinkler Irrigation

USDA-ARS?s Scientific Manuscript database

The development of site-specific sprinkler irrigation water management systems will be a major factor in future efforts to improve the various efficiencies of water-use and to support a sustainable irrigated environment. The challenge is to develop fully integrated management systems with supporting...

Integrated decision support, sensor networks and adaptive control for wireless site-specific sprinkler irrigation

USDA-ARS?s Scientific Manuscript database

The development of site-specific sprinkler irrigation water management systems will be a major factor in future efforts to improve the various efficiencies of water-use and to support a sustainable irrigated environment. The challenge is to develop fully integrated management systems with supporting...

Short and long term improvements in quality of chronic care delivery predict program sustainability.

PubMed

Cramm, Jane Murray; Nieboer, Anna Petra

2014-01-01

Empirical evidence on sustainability of programs that improve the quality of care delivery over time is lacking. Therefore, this study aims to identify the predictive role of short and long term improvements in quality of chronic care delivery on program sustainability. In this longitudinal study, professionals [2010 (T0): n=218, 55% response rate; 2011 (T1): n=300, 68% response rate; 2012 (T2): n=265, 63% response rate] from 22 Dutch disease-management programs completed surveys assessing quality of care and program sustainability. Our study findings indicated that quality of chronic care delivery improved significantly in the first 2 years after implementation of the disease-management programs. At T1, overall quality, self-management support, delivery system design, and integration of chronic care components, as well as health care delivery and clinical information systems and decision support, had improved. At T2, overall quality again improved significantly, as did community linkages, delivery system design, clinical information systems, decision support and integration of chronic care components, and self-management support. Multilevel regression analysis revealed that quality of chronic care delivery at T0 (p<0.001) and quality changes in the first (p<0.001) and second (p<0.01) years predicted program sustainability. In conclusion this study showed that disease-management programs based on the chronic care model improved the quality of chronic care delivery over time and that short and long term changes in the quality of chronic care delivery predicted the sustainability of the projects. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Study of space shuttle environmental control and life support problems

NASA Technical Reports Server (NTRS)

Dibble, K. P.; Riley, F. E.

1971-01-01

Four problem areas were treated: (1) cargo module environmental control and life support systems; (2) space shuttle/space station interfaces; (3) thermal control considerations for payloads; and (4) feasibility of improving system reusability.

Cost-effectiveness of an electronic clinical decision support system for improving quality of antenatal and childbirth care in rural Tanzania: an intervention study.

PubMed

Saronga, Happiness Pius; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell Ayindenaba; Wangwe, Peter; Sukums, Felix; Leshabari, Melkizedeck; Blank, Antje; Sauerborn, Rainer; Loukanova, Svetla

2017-08-07

QUALMAT project aimed at improving quality of maternal and newborn care in selected health care facilities in three African countries. An electronic clinical decision support system was implemented to support providers comply with established standards in antenatal and childbirth care. Given that health care resources are limited and interventions differ in their potential impact on health and costs (efficiency), this study aimed at assessing cost-effectiveness of the system in Tanzania. This was a quantitative pre- and post- intervention study involving 6 health centres in rural Tanzania. Cost information was collected from health provider's perspective. Outcome information was collected through observation of the process of maternal care. Incremental cost-effectiveness ratios for antenatal and childbirth care were calculated with testing of four models where the system was compared to the conventional paper-based approach to care. One-way sensitivity analysis was conducted to determine whether changes in process quality score and cost would impact on cost-effectiveness ratios. Economic cost of implementation was 167,318 USD, equivalent to 27,886 USD per health center and 43 USD per contact. The system improved antenatal process quality by 4.5% and childbirth care process quality by 23.3% however these improvements were not statistically significant. Base-case incremental cost-effectiveness ratios of the system were 2469 USD and 338 USD per 1% change in process quality for antenatal and childbirth care respectively. Cost-effectiveness of the system was sensitive to assumptions made on costs and outcomes. Although the system managed to marginally improve individual process quality variables, it did not have significant improvement effect on the overall process quality of care in the short-term. A longer duration of usage of the electronic clinical decision support system and retention of staff are critical to the efficiency of the system and can reduce the invested resources. Realization of gains from the system requires effective implementation and an enabling healthcare system. Registered clinical trial at www.clinicaltrials.gov ( NCT01409824 ). Registered May 2009.

Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

Treesearch

Erin K. Noonan-Wright; Tonja S. Opperman

2015-01-01

In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

Adaptive Intelligent Support to Improve Peer Tutoring in Algebra

ERIC Educational Resources Information Center

Walker, Erin; Rummel, Nikol; Koedinger, Kenneth R.

2014-01-01

Adaptive collaborative learning support (ACLS) involves collaborative learning environments that adapt their characteristics, and sometimes provide intelligent hints and feedback, to improve individual students' collaborative interactions. ACLS often involves a system that can automatically assess student dialogue, model effective and…

10 CFR 1706.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.2 Definitions. Advisory... support or improve policy development or decisionmaking by the Board, or management or administration of the Board, or to support or improve the operation of the Board's management systems. Such services may...

Integrating Continuing Professional Development With Health System Reform: Building Pillars of Support.

PubMed

Davis, David A; Rayburn, William F

2016-01-01

Clinical failures sparked a widespread desire for health system reform at the beginning of the 21st century, but related efforts have resulted in changes that are either slow or nonexistent. In response, academic medicine has moved in two directions: (1) system-wide reform using electronic health records, practice networks, and widespread data applications (a macro pathway); and (2) professional development of individual clinicians through continuous performance improvement (a micro pathway). Both pathways exist to improve patient care and population health, yet each suffers from limitations in widespread implementation. The authors call for a better union between these two parallel pathways through four pillars of support: (1) an acknowledgment that both pathways are essential to each other and to the final outcome they intend to achieve, (2) a strong faculty commitment to educate about quality improvement and patient safety at all education levels, (3) a reengineering of tools for professional development to serve as effective change agents, and (4) the development of standards to sustain this alignment of pathways. With these pillars of support integrating continuing professional development with health system reform, the authors envision a better functioning system, with improved metrics and value to enhance patient care and population health.

Best Practices for Teaming and Collaboration in the Interconnected Systems Framework

ERIC Educational Resources Information Center

Splett, Joni W.; Perales, Kelly; Halliday-Boykins, Colleen A.; Gilchrest, Callie E.; Gibson, Nicole; Weist, Mark D.

2017-01-01

The Interconnected Systems Framework (ISF) blends school mental health practices, systems, and resources into all levels of a multitiered system of supports (e.g., positive behavior interventions and supports). The ISF aims to improve mental health and school performance for all students by emphasizing effective school-wide promotion and…

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

7 CFR 1710.252 - Construction work plans-power supply borrowers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... operating systems of supporting power pools and to connect with adjacent power suppliers; (4) Improvements..., new substations and substation improvements and replacements, and Systems Control and Data Acquisition... include studies of load flows, voltage regulation, and stability characteristics to demonstrate system...

Achieving Continuous Improvement: Theories that Support a System Change.

ERIC Educational Resources Information Center

Armel, Donald

Focusing on improvement is different than focusing on quality, quantity, customer satisfaction, and productivity. This paper discusses Open System Theory, and suggests ways to change large systems. Changing a system (meaning the way all the parts are connected) requires a considerable amount of data gathering and analysis. Choosing the proper…

A Systemic Integration of Technology for New-Paradigm Education

ERIC Educational Resources Information Center

Watson, William R.; Watson, Sunnie Lee; Reigeluth, Charles M.

2012-01-01

Educational reform efforts have failed to create widespread improvement. The authors argue that rather than trying to improve the existing system of education, a new learner-centered paradigm is needed that supports individualized learning. Such a significantly different system of education will require the systemic application of technology to…

Adapting Nielsen’s Design Heuristics to Dual Processing for Clinical Decision Support

PubMed Central

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson’s standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access. PMID:28269915

Adapting Nielsen's Design Heuristics to Dual Processing for Clinical Decision Support.

PubMed

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson's standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access.

AI User Support System for SAP ERP

NASA Astrophysics Data System (ADS)

Vlasov, Vladimir; Chebotareva, Victoria; Rakhimov, Marat; Kruglikov, Sergey

2017-10-01

An intelligent system for SAP ERP user support is proposed in this paper. It enables automatic replies on users’ requests for support, saving time for problem analysis and resolution and improving responsiveness for end users. The system is based on an ensemble of machine learning algorithms of multiclass text classification, providing efficient question understanding, and a special framework for evidence retrieval, providing the best answer derivation.

Supporting self-care in general practice

PubMed Central

Greaves, Colin J; Campbell, John L

2007-01-01

There is both a clear need and a political will to improve self-care in long-term conditions: demand for self-care support interventions is rising. This article discusses current approaches to supporting self-care in primary care, evidence in favour of self-care support, and issues for GPs to consider in planning self-care support systems. In planning care pathways, important choices need to be made about whether to use individual or group-based approaches and what intensity of intervention is appropriate to match patient needs. Investment may also be needed in both health professional competences and practice systems to optimise their ability to support patient self-care. Self-care support is a key approach for the future of UK health care. Practices that are well trained and well organised to support self-care will respond better to the complex challenges of achieving improvements in the outcomes of long-term conditions. PMID:17925140

Patient-oriented Computerized Clinical Guidelines for Mobile Decision Support in Gestational Diabetes.

PubMed

García-Sáez, Gema; Rigla, Mercedes; Martínez-Sarriegui, Iñaki; Shalom, Erez; Peleg, Mor; Broens, Tom; Pons, Belén; Caballero-Ruíz, Estefanía; Gómez, Enrique J; Hernando, M Elena

2014-03-01

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients' self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient's access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients' personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients' acceptance of the whole system. © 2014 Diabetes Technology Society.

Systems of Support for Elementary School Principals: A Case Study

ERIC Educational Resources Information Center

Francone, Jennifer

2017-01-01

Principals need support throughout their careers in order to lead effectively and promote continuous improvement. However, some elementary school principals of small, rural schools lack access to structured systems of support that could increase their knowledge and skills as instructional leaders. The purpose of this study was to examine a central…

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

PubMed

Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight

2007-01-01

Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

Electronic prescribing in pediatrics: toward safer and more effective medication management.

PubMed

Johnson, Kevin B; Lehmann, Christoph U

2013-04-01

This technical report discusses recent advances in electronic prescribing (e-prescribing) systems, including the evidence base supporting their limitations and potential benefits. Specifically, this report acknowledges that there are limited but positive pediatric data supporting the role of e-prescribing in mitigating medication errors, improving communication with dispensing pharmacists, and improving medication adherence. On the basis of these data and on the basis of federal statutes that provide incentives for the use of e-prescribing systems, the American Academy of Pediatrics recommends the adoption of e-prescribing systems with pediatric functionality. This report supports the accompanying policy statement from the American Academy of Pediatrics recommending the adoption of e-prescribing by pediatric health care providers.

Design for improved maintenance of the fiber-optic cable system (As carried out in a concurrent engineering environment)

NASA Astrophysics Data System (ADS)

Tremoulet, P. C.

The author describes a number of maintenance improvements in the Fiber Optic Cable System (FOCS). They were achieved during a production phase pilot concurrent engineering program. Listed in order of importance (saved maintenance time and material) by maintenance level, they are: (1) organizational level: improved fiber optic converter (FOC) BITE; (2) Intermediate level: reduced FOC adjustments from 20 to 2; partitioned FOC into electrical and optical parts; developed cost-effective fault isolation test points and test using standard test equipment; improved FOC chassis to have lower mean time to repair; and (3) depot level: revised test requirements documents (TRDs) for common automatic test equipment and incorporated ATE testability into circuit and assemblies and application-specific integrated circuits. These improvements met this contract's tailored logistics MIL-STD 1388-1A requirements of monitoring the design for supportability and determining the most effective support equipment. Important logistics lessons learned while accomplishing these maintainability and supportability improvements on the pilot concurrent engineering program are also discussed.

Decision support system for health care resources allocation

PubMed Central

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-01-01

Background A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. Aim The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. Methods To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. Results A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. Conclusion In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff. PMID:28848645

Decision support system for health care resources allocation.

PubMed

Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

2017-06-01

A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

FY2016 Vehicle Systems Annual Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

Vehicle Systems is concerned with advancing light-, medium-, and heavy-duty (HD) vehicle systems to support DOE’s goals of developing technologies for the U.S. transportation sector that enhance national energy security,increase U.S. competitiveness in the global economy, and support improvement of U.S. transportation and energy infrastructure.

Improvements in Space Surveillance Processing for Wide Field of View Optical Sensors

NASA Astrophysics Data System (ADS)

Sydney, P.; Wetterer, C.

2014-09-01

For more than a decade, an autonomous satellite tracking system at the Air Force Maui Optical and Supercomputing (AMOS) observatory has been generating routine astrometric measurements of Earth-orbiting Resident Space Objects (RSOs) using small commercial telescopes and sensors. Recent work has focused on developing an improved processing system, enhancing measurement performance and response while supporting other sensor systems and missions. This paper will outline improved techniques in scheduling, detection, astrometric and photometric measurements, and catalog maintenance. The processing system now integrates with Special Perturbation (SP) based astrodynamics algorithms, allowing covariance-based scheduling and more precise orbital estimates and object identification. A merit-based scheduling algorithm provides a global optimization framework to support diverse collection tasks and missions. The detection algorithms support a range of target tracking and camera acquisition rates. New comprehensive star catalogs allow for more precise astrometric and photometric calibrations including differential photometry for monitoring environmental changes. This paper will also examine measurement performance with varying tracking rates and acquisition parameters.

A knowledge-based patient assessment system: conceptual and technical design.

PubMed Central

Reilly, C. A.; Zielstorff, R. D.; Fox, R. L.; O'Connell, E. M.; Carroll, D. L.; Conley, K. A.; Fitzgerald, P.; Eng, T. K.; Martin, A.; Zidik, C. M.; Segal, M.

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring. PMID:11079970

A knowledge-based patient assessment system: conceptual and technical design.

PubMed

Reilly, C A; Zielstorff, R D; Fox, R L; O'Connell, E M; Carroll, D L; Conley, K A; Fitzgerald, P; Eng, T K; Martin, A; Zidik, C M; Segal, M

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring.

The Air Force Needs to Improve Cost-Effectiveness and Availability of the Joint Surveillance Target Attack Radar System (Redacted)

DTIC Science & Technology

2016-11-01

Target Attack Radar System Objective We determined whether the Air Force made cost-effective purchases on the performance-based logistics contract to... contract to Northrop Grumman Corporation to provide Total System Support Responsibility services to sustain 16 E-8C JSTARS aircraft. These services...customer support. The Total System Support Responsibility contract is valued at $7 billion, with a 6-year base period and 16 annual contract option

Measuring sustainment of prevention programs and initiatives: a study protocol.

PubMed

Palinkas, Lawrence A; Spear, Suzanne E; Mendon, Sapna J; Villamar, Juan; Valente, Thomas; Chou, Chi-Ping; Landsverk, John; Kellam, Shepperd G; Brown, C Hendricks

2016-07-16

Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the term "sustainment" and what factors predict or even measure sustainability of effective prevention programs and support systems. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and identify and support both the unique requirements for improving sustainability for each program as well as for developing a generalizable framework comprised of core components of sustainment across diverse prevention approaches. Based on an analysis of qualitative and quantitative data of 10 grantees supported by these four programs, we will develop a flexible measurement system, with both general and specific components, that can bring precision to monitoring sustainment of infrastructure, activities, and outcomes for each prevention approach. We will then transform this system for use in evaluating and improving the likelihood of achieving prevention effort sustainment. To achieve these goals, we will (1) identify core components of sustainment of prevention programs and their support infrastructures; (2) design a measurement system for monitoring and providing feedback regarding sustainment within the four SAMHSA's prevention-related grant programs; and (3) pilot test the predictability of this multilevel measurement system across these programs and the feasibility and acceptability of a measurement system to evaluate and improve the likelihood of sustainment. This project is intended to improve sustainment of the supporting prevention infrastructure, activities, and outcomes that are funded by federal, state, community, and foundation sources.

Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

PubMed

Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

2015-07-01

Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

Smart homes and ambient assisted living applications: from data to knowledge-empowering or overwhelming older adults? Contribution of the IMIA Smart Homes and Ambiant Assisted Living Working Group.

PubMed

Demiris, G; Thompson, H

2011-01-01

As health care systems face limited resources and workforce shortages to address the complex needs of older adult populations, innovative approaches utilizing information technology can support aging. Smart Home and Ambient Assisted Living (SHAAL) systems utilize advanced and ubiquitous technologies including sensors and other devices that are integrated in the residential infrastructure or wearable, to capture data describing activities of daily living and health related events. This paper highlights how data from SHAAL systems can lead to information and knowledge that ultimately improves clinical outcomes and quality of life for older adults as well as quality of health care services. We conducted a review of personal health record applications specifically for older adults and approaches to using information to improve elder care. We present a framework that showcases how data captured from SHAAL systems can be processed to provide meaningful information that becomes part of a personal health record. Synthesis and visualization of information resulting from SHAAL systems can lead to knowledge and support education, delivery of tailored interventions and if needed, transitions in care. Such actions can involve multiple stakeholders as part of shared decision making. SHAAL systems have the potential to support aging and improve quality of life and decision making for older adults and their families. The framework presented in this paper demonstrates how emphasis needs to be placed into extracting meaningful information from new innovative systems that will support decision making. The challenge for informatics designers and researchers is to facilitate an evolution of SHAAL systems expanding beyond demonstration projects to actual interventions that will improve health care for older adults.

Multiscale Methods for Accurate, Efficient, and Scale-Aware Models of the Earth System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldhaber, Steve; Holland, Marika

The major goal of this project was to contribute improvements to the infrastructure of an Earth System Model in order to support research in the Multiscale Methods for Accurate, Efficient, and Scale-Aware models of the Earth System project. In support of this, the NCAR team accomplished two main tasks: improving input/output performance of the model and improving atmospheric model simulation quality. Improvement of the performance and scalability of data input and diagnostic output within the model required a new infrastructure which can efficiently handle the unstructured grids common in multiscale simulations. This allows for a more computationally efficient model, enablingmore » more years of Earth System simulation. The quality of the model simulations was improved by reducing grid-point noise in the spectral element version of the Community Atmosphere Model (CAM-SE). This was achieved by running the physics of the model using grid-cell data on a finite-volume grid.« less

Student Support in Australia: When Will the Government Improve It?

ERIC Educational Resources Information Center

Dobson, Ian R.

2005-01-01

The recent Government inquiry into student income support noted that there was "conclusive evidence that the income support system is in a serious state of disrepair and that nothing short of a major policy review and overhaul of the system is required". The report of the inquiry produced 15 common sense recommendations, but Government…

Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps

PubMed Central

Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B.; Seguin, Rebecca A.

2015-01-01

A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers’ markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits. PMID:26613066

Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps.

PubMed

Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B; Seguin, Rebecca A

A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers' markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits.

A Novel and Intelligent Home Monitoring System for Care Support of Elders with Cognitive Impairment.

PubMed

Lazarou, Ioulietta; Karakostas, Anastasios; Stavropoulos, Thanos G; Tsompanidis, Theodoros; Meditskos, Georgios; Kompatsiaris, Ioannis; Tsolaki, Magda

2016-10-18

Assistive technology, in the form of a smart home environment, is employed to support people with dementia. To propose a system for continuous and objective remote monitoring of problematic daily living activity areas and design personalized interventions based on system feedback and clinical observations for improving cognitive function and health-related quality of life. The assistive technology of the proposed system, including wearable, sleep, object motion, presence, and utility usage sensors, was methodically deployed at four different home installations of people with cognitive impairment. Detection of sleep patterns, physical activity, and activities of daily living, based on the collected sensor data and analytics, was available at all times through comprehensive data visualization solutions. Combined with clinical observation, targeted psychosocial interventions were introduced to enhance the participants' quality of life and improve their cognitive functions and daily functionality. Meanwhile, participants and their caregivers were able to visualize a reduced set of information tailored to their needs. Overall, paired-sample t-test analysis of monitored qualities revealed improvement for all participants in neuropsychological assessment. Moreover, improvement was detected from the beginning to the end of the trial, in physical condition and in the domains of sleep. Detecting abnormalities via the system, for example in sleep quality, such as REM sleep, has proved to be critical to assess current status, drive interventions, and evaluate improvements in a reliable manner. It has been proved that the proposed system is suitable to support clinicians to reliably drive and evaluate clinical interventions toward quality of life improvement of people with cognitive impairment.

Geographic Health Information Systems: A Platform To Support The ‘Triple Aim’

PubMed Central

Miranda, Marie Lynn; Ferranti, Jeffrey; Strauss, Benjamin; Neelon, Brian; Califf, Robert M.

2014-01-01

Despite the rapid growth of electronic health data, most data systems do not connect individual patient records to data sets from outside the health care delivery system. These isolated data systems cannot support efforts to recognize or address how the physical and environmental context of each patient influences health choices and health outcomes. In this article we describe how a geographic health information system in Durham, North Carolina, links health system and social and environmental data via shared geography to provide a multidimensional understanding of individual and community health status and vulnerabilities. Geographic health information systems can be useful in supporting the Institute for Healthcare Improvement’s Triple Aim Initiative to improve the experience of care, improve the health of populations, and reduce per capita costs of health care. A geographic health information system can also provide a comprehensive information base for community health assessment and intervention for accountable care that includes the entire population of a geographic area. PMID:24019366

Social organization of self-management support of persons with diabetes: a health systems comparison.

PubMed

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

IMPROVEMENT SUPPORT RESEARCH OF LOCAL DISASTER PREVENTION POWER USING THE FIRE SPREADING SIMULATION SYSTEM IN CASE OF A BIG EARTHQUAKE

NASA Astrophysics Data System (ADS)

Futagami, Toru; Omoto, Shohei; Hamamoto, Kenichirou

This research describes the risk communication towards improvement in the local disaster prevention power for Gobusho town in Marugame city which is only a high density city area in Kagawa Pref. Specifically, the key persons and authors of the area report the practice research towards improvement in the local disaster prevention power by the PDCA cycle of the area, such as formation of local voluntary disaster management organizations and implementation of an emergency drill, applying the fire spreading simulation system in case of a big earthquake. The fire spreading simulation system in case of the big earthquake which authors are developing describes the role and subject which have been achieved to BCP of the local community as a support system.

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

PubMed

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

75 FR 51091 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... relations, partnerships, and alliances with STLT health officials, and national and regional public health... Support (OSTLTS) is to improve the capacity and performance of the public health system. To carry out its..., tribal, local, and territorial (STLT) public health agencies; (2) supports the improvement of performance...

Improving the Utilisation of Management Information Systems in Secondary Schools

ERIC Educational Resources Information Center

Bosker, R. J.; Branderhorst, E. M.; Visscher, A. J.

2007-01-01

Although most secondary schools do use management information systems (MISs), these systems tend not to be used to support higher order managerial activities but are currently primarily used for clerical purposes. This situation is unsatisfactory as MISs fully utilised could offer invaluable support to schools, which are increasingly being granted…

Computerized Information and Support for Patients with Breast Cancer or HIV Infection.

ERIC Educational Resources Information Center

Rolnick, Sharon J.; Owens, Betta; Botta, Renee; Sathe, Laurie; Hawkins, Robert; Cooper, Leah; Kelley, Mary; Gustafson, David

1999-01-01

Use of the Comprehensive Health Enhancement Support System, a computerized information system, by patients with breast cancer or HIV was compared. Groups differed in the frequency of access and use of certain aspects (e.g., discussion groups). Identification of patient concerns provided useful information for system improvements. (SK)

Establishment and outcomes of a model primary care pharmacy service system.

PubMed

Carmichael, Jannet M; Alvarez, Autumn; Chaput, Ryan; DiMaggio, Jennifer; Magallon, Heather; Mambourg, Scott

2004-03-01

The establishment and outcomes of a model primary care pharmacy service system are described. A primary care pharmacy practice model was established at a government health care facility in March 1996. The original objective was to establish a primary pharmacy practice model that would demonstrate improved patient outcomes and maximize the pharmacist's contributions to drug therapy. Since its inception, many improvements have been realized and supported by advanced computer and automated systems, expanded disease state management practices, and unique practitioner and administrative support. Many outcomes studies have been performed on the pharmacist-initiated and -managed clinics, leading to improved patient care and conveying the quality-conscious and cost-effective role pharmacists can play as independent practitioners in this environment. These activities demonstrate cutting-edge leadership in health-system pharmacy. Redesign has been used to improve consistent access to a medication expert and has significantly improved the quality of patient care while easing physicians' workload without increasing health care costs. A system using pharmacists as independent practitioners to promote primary care has achieved high-quality and cost-effective patient care.

Professional Growth & Support Spending Calculator

ERIC Educational Resources Information Center

Education Resource Strategies, 2013

2013-01-01

This "Professional Growth & Support Spending Calculator" helps school systems quantify all current spending aimed at improving teaching effectiveness. Part I provides worksheets to analyze total investment. Part II provides a system for evaluating investments based on purpose, target group, and delivery. In this Spending Calculator…

COMMUNITY MULTISCALE AIR QUALITY MODELING SYSTEM (ONE ATMOSPHERE)

EPA Science Inventory

This task supports ORD's strategy by providing responsive technical support of EPA's mission and provides credible state of the art air quality models and guidance. This research effort is to develop and improve the Community Multiscale Air Quality (CMAQ) modeling system, a mu...

Improving the Weight of the Nation by engaging the medical setting in obesity prevention and control.

PubMed

Foltz, Jennifer L; Belay, Brook; Blackburn, George L

2013-01-01

This manuscript highlights examples of strategies that have made strides in improving the quality of health care environments, systems-level improvements to support self-management, and collaborations between primary care and public health to support effective approaches to prevent obesity among children and adults in the U.S. © 2013 American Society of Law, Medicine & Ethics, Inc.

Driving Improvement with a Balanced Scorecard

ERIC Educational Resources Information Center

Cowart, Scott K.

2010-01-01

This article describes how a school district's use of a transparent tool coalesced support for systemic improvement. The author was looking for a way to push improvement in his 4,000-student school system when he discovered the balanced scorecard, a strategic tool for performance management. The author details how the balanced scorecard helped him…

Are Integrated Portfolio Systems the Answer? An Evaluation of a Web-Based Portfolio System to Improve Preservice Teachers' Reflective Thinking Skills

ERIC Educational Resources Information Center

Oner, Diler; Adadan, Emine

2016-01-01

This study investigated the effectiveness of an integrated web-based portfolio system, namely the BOUNCE System, which primarily focuses on improving preservice teachers' reflective thinking skills. BOUNCE©, the software component of the system, was designed and developed to support a teaching practice model including a cycle of activities to be…

Implementation and Outcomes of Kansas Multi-Tier System of Supports: Final Evaluation Report-2014

ERIC Educational Resources Information Center

Reedy, Kristen; Lacireno-Paquet, Natalie

2015-01-01

Implementation of multi-tier system of supports (MTSS) has grown rapidly in Kansas and is a key strategy for turning around low-performing schools in the state. MTSS is designed to improve outcomes for all students by instituting system-level change across the classroom, school, district, and state. Such systemic change is accomplished by…

How Can a Global Social Support System Hope to Achieve Fairer Competiveness?

PubMed Central

Goldblatt, Peter

2016-01-01

Ooms et al sets out some good general principles for a global social support system to improve fairer global competitiveness as a result of redistribution. This commentary sets out to summarize some of the conditions that would need to be satisfied for it to level up gradients in inequality through such a social support system, using the National Basketball Association (NBA) example as a point of reference. From this, the minimal conditions are described that would be required for the support system, proposed in the article by Ooms et al, to succeed. PMID:26927594

System design and improvement of an emergency department using Simulation-Based Multi-Objective Optimization

NASA Astrophysics Data System (ADS)

Goienetxea Uriarte, A.; Ruiz Zúñiga, E.; Urenda Moris, M.; Ng, A. H. C.

2015-05-01

Discrete Event Simulation (DES) is nowadays widely used to support decision makers in system analysis and improvement. However, the use of simulation for improving stochastic logistic processes is not common among healthcare providers. The process of improving healthcare systems involves the necessity to deal with trade-off optimal solutions that take into consideration a multiple number of variables and objectives. Complementing DES with Multi-Objective Optimization (SMO) creates a superior base for finding these solutions and in consequence, facilitates the decision-making process. This paper presents how SMO has been applied for system improvement analysis in a Swedish Emergency Department (ED). A significant number of input variables, constraints and objectives were considered when defining the optimization problem. As a result of the project, the decision makers were provided with a range of optimal solutions which reduces considerably the length of stay and waiting times for the ED patients. SMO has proved to be an appropriate technique to support healthcare system design and improvement processes. A key factor for the success of this project has been the involvement and engagement of the stakeholders during the whole process.

Improving precise positioning of surgical robotic instruments by a three-side-view presentation system on telesurgery.

PubMed

Hori, Kenta; Kuroda, Tomohiro; Oyama, Hiroshi; Ozaki, Yasuhiko; Nakamura, Takehiko; Takahashi, Takashi

2005-12-01

For faultless collaboration among the surgeon, surgical staffs, and surgical robots in telesurgery, communication must include environmental information of the remote operating room, such as behavior of robots and staffs, vital information of a patient, named supporting information, in addition to view of surgical field. "Surgical Cockpit System, " which is a telesurgery support system that has been developed by the authors, is mainly focused on supporting information exchange between remote sites. Live video presentation is important technology for Surgical Cockpit System. Visualization method to give precise location/posture of surgical instruments is indispensable for accurate control and faultless operation. In this paper, the authors propose three-side-view presentation method for precise location/posture control of surgical instruments in telesurgery. The experimental results show that the proposed method improved accurate positioning of a telemanipulator.

DoD Weapon System Acquisition Reform Product Support Assessment

DTIC Science & Technology

2009-11-01

can be best effected by working through the Defense Acquisition University, the Logistics Functional IPT, the Acquisition Management Functional... WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Department of Defense,Undersecretary of Defense for Acquisition,Technology and...each year in product support. Reformed stewardship—driven by improving product support and achieving more cost- effective weapon system readiness

EPAS: A System that Works

ERIC Educational Resources Information Center

ACT, Inc., 2006

2006-01-01

ACT's Educational Planning and Assessment System (EPAS[R]) is designed to guide and support schools, districts, and states in their efforts to improve students' readiness for life after high school. EPAS provides a longitudinal approach to educational and career planning, assessment, instructional support, and evaluation. EPAS components are…

Phase Change Permeation Technology For Environmental Control Life Support Systems

NASA Technical Reports Server (NTRS)

Wheeler, Raymond M.

2014-01-01

Use of a phase change permeation membrane (Dutyion [Trademark]) to passively and selectively mobilize water in microgravity to enable improved water recovery from urine/brine for Environment Control and Life Support Systems (ECLSS) and water delivery to plans for potential use in microgravity.

Health and rescue services management system during a crisis event

PubMed Central

Nicolaidou, Iolie; Hadjichristofi, George; Kyprianou, Stelios; Christou, Synesios; Constantinou, Riana

2016-01-01

Τhe performance of rescuers and personnel handling major emergencies or crisis events can be significantly improved through continuous training and through technology support. The work done in order to create a system has been discussed which can support both resources and victims during a crisis or major emergency event. More specifically, the system supports real-time management of firefighter teams, rescue teams, health services, and victims during a major disaster. It can be deployed in an ad hoc manner in the disaster area, as a stand-alone infrastructure (using its own telecommunications and power). It mainly consists of a control station, which is installed in the area command centre, the firefighters units, the rescuers units, the ambulance vehicles units, and the telemedicine units that can be used in order to support victim handling at the casualties clearing station. The system has been tested and improved through continuous communication with experts and through professional exercises; the results and conclusions are presented. PMID:27733928

Development and Piloting of a Classroom-focused Measurement Feedback System

PubMed Central

Nadeem, Erum; Cappella, Elise; Holland, Sibyl; Coccaro, Candace; Crisonino, Gerard

2015-01-01

The present study used a community partnered research method to develop and pilot a classroom-focused measurement feedback system (MFS) for school mental health providers to support teachers’ use of effective universal and target classroom practices related to student emotional and behavioral issues. School personnel from seven urban elementary and middle school classrooms participated. Phase I involved development and refinement of the system through a baseline needs assessment and rapid-cycle feedback. Phase II involved detailed case study analysis of pre-to-post quantitative and implementation process data. Results suggest that teachers who used the dashboard along with consultation showed improvement in observed classroom organization and emotional support. Results also suggest that MFS use was tied closely to consultation dose, and that broader support at the school level was critical. Classroom-focused MFSs are a promising tool to support classroom improvement, and warrant future research focused on their effectiveness and broad applicability. PMID:25894312

Mental Health Collaborative Care and Its Role in Primary Care Settings

PubMed Central

Goodrich, David E.; Kilbourne, Amy M.; Nord, Kristina M.; Bauer, Mark S.

2013-01-01

Collaborative care models (CCMs) provide a pragmatic strategy to deliver integrated mental health and medical care for persons with mental health conditions served in primary care settings. CCMs are team-based intervention to enact system-level redesign by improving patient care through organizational leadership support, provider decision support, and clinical information systems as well as engaging patients in their care through self-management support and linkages to community resources. The model is also a cost-efficient strategy for primary care practices to improve outcomes for a range of mental health conditions across populations and settings. CCMs can help achieve integrated care aims under healthcare reform yet organizational and financial issues may affect adoption into routine primary care. Notably, successful implementation of CCMs in routine care will require alignment of financial incentives to support systems redesign investments, reimbursements for mental health providers, and adaptation across different practice settings and infrastructure to offer all CCM components. PMID:23881714

Mental health collaborative care and its role in primary care settings.

PubMed

Goodrich, David E; Kilbourne, Amy M; Nord, Kristina M; Bauer, Mark S

2013-08-01

Collaborative care models (CCMs) provide a pragmatic strategy to deliver integrated mental health and medical care for persons with mental health conditions served in primary care settings. CCMs are team-based intervention to enact system-level redesign by improving patient care through organizational leadership support, provider decision support, and clinical information systems, as well as engaging patients in their care through self-management support and linkages to community resources. The model is also a cost-efficient strategy for primary care practices to improve outcomes for a range of mental health conditions across populations and settings. CCMs can help achieve integrated care aims underhealth care reform yet organizational and financial issues may affect adoption into routine primary care. Notably, successful implementation of CCMs in routine care will require alignment of financial incentives to support systems redesign investments, reimbursements for mental health providers, and adaptation across different practice settings and infrastructure to offer all CCM components.

48 CFR 2.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... support or improve: organizational policy development; decision-making; management and administration... organizations, activities (including management and support services for R&D activities), or systems. These..., decision-making, management, or administration. Included are studies in support of R&D activities. Also...

48 CFR 2.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... support or improve: organizational policy development; decision-making; management and administration... organizations, activities (including management and support services for R&D activities), or systems. These..., decision-making, management, or administration. Included are studies in support of R&D activities. Also...

SpaceOps 1992: Proceedings of the Second International Symposium on Ground Data Systems for Space Mission Operations

NASA Technical Reports Server (NTRS)

1993-01-01

The Second International Symposium featured 135 oral presentations in these 12 categories: Future Missions and Operations; System-Level Architectures; Mission-Specific Systems; Mission and Science Planning and Sequencing; Mission Control; Operations Automation and Emerging Technologies; Data Acquisition; Navigation; Operations Support Services; Engineering Data Analysis of Space Vehicle and Ground Systems; Telemetry Processing, Mission Data Management, and Data Archiving; and Operations Management. Topics focused on improvements in the productivity, effectiveness, efficiency, and quality of mission operations, ground systems, and data acquisition. Also emphasized were accomplishments in management of human factors; use of information systems to improve data retrieval, reporting, and archiving; design and implementation of logistics support for mission operations; and the use of telescience and teleoperations.

Tracking and data system support for the Pioneer project. Volume 2: Pioneer 11 prelaunch planning through second trajectory correction, to 1 May 1973

NASA Technical Reports Server (NTRS)

Barton, W. R.; Miller, R. B.

1975-01-01

The tracking and data system support of the planning, testing, launch, near-earth, and deep space phases of the Pioneer 11 Jupiter Mission are described, including critical phases of spacecraft flight and guidance. Scientific instruments aboard the spacecraft registered information relative to interplanetary particles and fields. Knowledge of the celestial mechanics of the solar system was improved through radiometric data gathering. Network performance, details of network support activity, and special support activities are discussed.

ORAC: a modern observing system for UKIRT

NASA Astrophysics Data System (ADS)

Bridger, Alan; Wright, Gillian S.; Economou, Frossie; Tan, Min; Currie, Malcolm J.; Pickup, David A.; Adamson, Andrew J.; Rees, Nicholas P.; Purves, Maren; Kackley, Russell

2000-06-01

The steady improvement in telescope performance at UKIRT and the increase in data acquisition rates led to a strong desired for an integrated observing framework that would meet the needs of future instrumentation, as well as providing some support for existing instrumentation. Thus the Observatory Reduction and Acquisition Control (ORAC) project was created in 1997 with the goals of improving the scientific productivity in the telescope, reducing the overall ongoing support requirements, and eventually supporting the use of more flexibly scheduled observing. The project was also expected to achieve this within a tight resource allocation. In October 1999 the ORAC system was commissioned at the United Kingdom Infrared Telescope.

Dual-function magnetic structure for toroidal plasma devices

DOEpatents

Brown, Robert L.

1978-01-01

This invention relates to a support system wherein the iron core and yoke of the plasma current system of a tokamak plasma containment device is redesigned to support the forces of the magnet coils. The containment rings, which occupy very valuable space around the magnet coils, are utilized to serve as yokes for the core such that the conventional yoke is eliminated. The overall result is an improved aspect ratio, reduction in structure, smaller overall size, and improved access to the plasma ring.

Shared care dyadic intervention: outcome patterns for heart failure care partners.

PubMed

Sebern, Margaret D; Woda, Aimee

2012-04-01

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents a system of processes used in family care to exchange support. Key findings were as follows: the SCDI was acceptable to both care partners and the data supported improved shared care for both. For the patient, there were improvements in self-care. For the caregivers, there were improvements in relationship quality and health.

Building a Networked Improvement Community to Promote Equitable, Coherent Systems of Science Education: How a State-Level Team Can Support District-Level Change Efforts

ERIC Educational Resources Information Center

Penuel, William R.; Shaw, Sam; Bell, Philip; Hopkins, Megan; Neill, Tiffany; Farrell, Caitlin C.

2018-01-01

This paper describes a Networked Improvement Community comprised of a network of 13 states focused on improving coherence and equity in state systems of science education. Grounded in principles of improvement science adapted from healthcare, we are developing and testing resources for formative assessment in science, with the aim of developing…

Methods and Costs to Achieve Ultra Reliable Life Support

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2012-01-01

A published Mars mission is used to explore the methods and costs to achieve ultra reliable life support. The Mars mission and its recycling life support design are described. The life support systems were made triply redundant, implying that each individual system will have fairly good reliability. Ultra reliable life support is needed for Mars and other long, distant missions. Current systems apparently have insufficient reliability. The life cycle cost of the Mars life support system is estimated. Reliability can be increased by improving the intrinsic system reliability, adding spare parts, or by providing technically diverse redundant systems. The costs of these approaches are estimated. Adding spares is least costly but may be defeated by common cause failures. Using two technically diverse systems is effective but doubles the life cycle cost. Achieving ultra reliability is worth its high cost because the penalty for failure is very high.

How Can a Global Social Support System Hope to Achieve Fairer Competiveness? Comment on "A Global Social Support System: What the International Community Could Learn From the United States' National Basketball Association".

PubMed

Goldblatt, Peter

2015-12-25

Ooms et al sets out some good general principles for a global social support system to improve fairer global competitiveness as a result of redistribution. This commentary sets out to summarize some of the conditions that would need to be satisfied for it to level up gradients in inequality through such a social support system, using the National Basketball Association (NBA) example as a point of reference. From this, the minimal conditions are described that would be required for the support system, proposed in the article by Ooms et al, to succeed. © 2016 by Kerman University of Medical Sciences.

Utilizing a Low-Cost, Laser-Driven Interactive System (LaDIS) to Improve Learning in Developing Rural Regions

ERIC Educational Resources Information Center

Liou, Wei-Kai; Chang, Chun-Yen

2014-01-01

This study proposes an innovation Laser-Driven Interactive System (LaDIS), utilizing general IWBs (Interactive Whiteboard) didactics, to support student learning for rural and developing regions. LaDIS is a system made to support traditional classroom practices between an instructor and a group of students. This invention effectively transforms a…

Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

ERIC Educational Resources Information Center

Campbell, Merle Wayne

2013-01-01

Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

State-Level High School Improvement Systems Checklist

ERIC Educational Resources Information Center

National High School Center, 2007

2007-01-01

This checklist is designed to help states at various stages develop their system of support to reach struggling high schools. The checklist can be used to assess where your state is in terms of the elements of using existing support and guidance mechanisms, and reconfiguring and/or creating new structures to leverage system change for high school…

Effective Practices for Mentoring Beginning Middle School Teachers: Mentor's Perspectives

ERIC Educational Resources Information Center

Sowell, Marsha

2017-01-01

In order to improve student achievement, school systems must provide new teachers with support to become effective teachers more quickly. Educators frequently use mentoring to support new teachers and reach the goals of improved classroom performance as well as teacher retention. The intention in this study was to provide insights into the…

Improving the quality of cancer care in America through health information technology.

PubMed

Feeley, Thomas W; Sledge, George W; Levit, Laura; Ganz, Patricia A

2014-01-01

A recent report from the Institute of Medicine titled Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, identifies improvement in information technology (IT) as essential to improving the quality of cancer care in America. The report calls for implementation of a learning healthcare IT system: a system that supports patient-clinician interactions by providing patients and clinicians with the information and tools necessary to make well informed medical decisions and to support quality measurement and improvement. While some elements needed for a learning healthcare system are already in place for cancer, they are incompletely implemented, have functional deficiencies, and are not integrated in a way that creates a true learning healthcare system. To achieve the goal of a learning cancer care delivery system, clinicians, professional organizations, government, and the IT industry will have to partner, develop, and incentivize participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

AmeriFlux Data System Looking Forward

NASA Astrophysics Data System (ADS)

Agarwal, D.; Cheah, Y. W.; Chu, H.; Keenan, T. F.; Pastorello, G.; Torn, M. S.; Humphrey, M.; Beekwilder, N.

2016-12-01

The AmeriFlux data system is turning 20 along with the network. This anniversary provides an opportunity to reimagine the data system and services to support the next 20 years of AmeriFlux. The next generation goals of the data system will be continuous data quality and consistency improvements, and also increased services to both tower owners and data users. An example change is new data citation capabilities and support leveraging Digital Object Identifiers (DOI) to enable easier citation and improved tracking of data usage. A new processing pipeline will enable more regular production of gap-filled and partitioned datasets. Automation will be continuously increased to help improve the time from data submission to user data availability. New standard data submission and processing formats will enable automation of the data submission and improved QA/QC processes. This new data system is made possible by the extensive work that the AmeriFlux data team at CDIAC has done over the last 20 years in close collaboration with the tower teams. This presentation will provide both a historical perspective and a vision for the future of the AmeriFlux data system.

Improving Performance Of Industrial Enterprises With CGT

NASA Astrophysics Data System (ADS)

Dolgih, I. N.; Bannova, K. A.; Kuzmina, N. A.; Zdanova, A. B.

2016-04-01

At the present day, a falling in the overall level of efficiency production activities, especially in the machine-building companies makes it necessary to development various actions in the State support, including through the creation consolidated taxation system. Such support will help improve efficiency of activity not only the industrial companies, but also will allow improve economic and social situation in regions where often large engineering factories is city-forming.

Scotland's Knowledge Network: translating knowledge into action to improve quality of care.

PubMed

Wales, A; Graham, S; Rooney, K; Crawford, A

2012-11-01

The Knowledge Network (www.knowledge.scot.nhs.uk) is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.

Humanoid Flight Metabolic Simulator Project

NASA Technical Reports Server (NTRS)

Ross, Stuart

2015-01-01

NASA's Evolvable Mars Campaign (EMC) has identified several areas of technology that will require significant improvements in terms of performance, capacity, and efficiency, in order to make a manned mission to Mars possible. These include crew vehicle Environmental Control and Life Support System (ECLSS), EVA suit Portable Life Support System (PLSS) and Information Systems, autonomous environmental monitoring, radiation exposure monitoring and protection, and vehicle thermal control systems (TCS). (MADMACS) in a Suit can be configured to simulate human metabolism, consuming crew resources (oxygen) in the process. In addition to providing support for testing Life Support on unmanned flights, MADMACS will also support testing of suit thermal controls, and monitor radiation exposure, body zone temperatures, moisture, and loads.

MIDAS Website. Revised

NASA Technical Reports Server (NTRS)

Goodman, Allen; Shively, R. Joy (Technical Monitor)

1997-01-01

MIDAS, Man-machine Integration Design and Analysis System, is a unique combination of software tools aimed at reducing design cycle time, supporting quantitative predictions of human-system effectiveness and improving the design of crew stations and their associated operating procedures. This project is supported jointly by the US Army and NASA.

Air Force Tech Order Management System (AFTOMS). Automation Plan-Final Report. Version 1.0

DOT National Transportation Integrated Search

1988-02-01

Computer aided Acquisition and Logistics Support (CALS) is a Department of Defense (DoD) program designed to improve weapon systems support through digital automation. In June 1985, the joint industry/DoD Task Force on CALS issued a five volume repor...

Airborne Cloud Computing Environment (ACCE)

NASA Technical Reports Server (NTRS)

Hardman, Sean; Freeborn, Dana; Crichton, Dan; Law, Emily; Kay-Im, Liz

2011-01-01

Airborne Cloud Computing Environment (ACCE) is JPL's internal investment to improve the return on airborne missions. Improve development performance of the data system. Improve return on the captured science data. The investment is to develop a common science data system capability for airborne instruments that encompasses the end-to-end lifecycle covering planning, provisioning of data system capabilities, and support for scientific analysis in order to improve the quality, cost effectiveness, and capabilities to enable new scientific discovery and research in earth observation.

Improved Conceptual Models Methodology (ICoMM) for Validation of Non-Observable Systems

DTIC Science & Technology

2015-12-01

distribution is unlimited IMPROVED CONCEPTUAL MODELS METHODOLOGY (ICoMM) FOR VALIDATION OF NON-OBSERVABLE SYSTEMS by Sang M. Sok December 2015...REPORT TYPE AND DATES COVERED Dissertation 4. TITLE AND SUBTITLE IMPROVED CONCEPTUAL MODELS METHODOLOGY (ICoMM) FOR VALIDATION OF NON-OBSERVABLE...importance of the CoM. The improved conceptual model methodology (ICoMM) is developed in support of improving the structure of the CoM for both face and

The potential for intelligent decision support systems to improve the quality and consistency of medication reviews.

PubMed

Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P

2012-08-01

Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into improved medication usage if they were implemented into routine use. © 2011 Blackwell Publishing Ltd.

An information system to improve financial management, resource allocation and activity planning: evaluation results.

PubMed

Ruland, C M; Ravn, I H

2001-01-01

An important strategy for improving resource management and cost containment in health care is to develop information systems that assist hospital managers in financial management, resource allocation, and activity planning. A crucial part of such development is a rigorous evaluation to assess whether the system accomplishes it's intended goals. To evaluate CLASSICA, a Decision Support System (DSS), that assists nurse managers in financial management, resource allocation, staffing, and activity planning. Using a pre-post test design with control units, CLASSICA was evaluated in four test units. Baseline data and simultaneous parallel measures were collected prior to system implementation at test sites and control units. Using expense reports, staffing and financial statistics, surveys, interviews with nurse managers, and logs as data sources, CLASSICA was evaluated on: cost reduction, quality of management information; usefulness as decision support for improved financial management and decision-making; user satisfaction; and ease of use. Evaluation results showed a 41% reduction in expenditures for overtime and extra hours as compared to a 1.8% reduction in control units during the same time period. Users reported a significant improvement in management information; nurse managers stated that they had gained control over costs. The system helped them analyze the relationships between patient activity staffing, and cost of care. Users reported high satisfaction with the system, the information and decision support it provided, and its ease of use. These results suggest that CLASSICA is a DSS that successfully assists nurse managers in cost effective management of their units.

Improving oxygen therapy for children and neonates in secondary hospitals in Nigeria: study protocol for a stepped-wedge cluster randomised trial.

PubMed

Graham, Hamish R; Ayede, Adejumoke I; Bakare, Ayobami A; Oyewole, Oladapo B; Peel, David; Gray, Amy; McPake, Barbara; Neal, Eleanor; Qazi, Shamim; Izadnegahdar, Rasa; Falade, Adegoke G; Duke, Trevor

2017-10-27

Oxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity. This trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria. The improved oxygen system includes: a standardised equipment package; training of clinical and technical staff; infrastructure support (including improved power supply); and quality improvement activities such as supportive supervision. Phase 1 will involve the introduction of pulse oximetry alone; phase 2 will involve the introduction of the full, improved oxygen system package. We have based the intervention design on a theory-based analysis of previous oxygen projects, and used quality improvement principles, evidence-based teaching methods, and behaviour-change strategies. We are using a stepped-wedge cluster randomised design with participating hospitals randomised to receive an improved oxygen system at 4-month steps (three hospitals per step). Our mixed-methods evaluation will evaluate effectiveness, impact, sustainability, process and fidelity. Our primary outcome measures are childhood pneumonia case fatality rate and inpatient neonatal mortality rate. Secondary outcome measures include a range of clinical, quality of care, technical, and health systems outcomes. The planned study duration is from 2015 to 2018. Our study will provide quality evidence on the effectiveness of improved oxygen systems, and how to better implement and scale-up oxygen systems in resource-limited settings. Our results should have important implications for policy-makers, hospital administrators, and child health organisations in Africa and globally. Australian New Zealand Clinical Trials Registry: ACTRN12617000341325 . Retrospectively registered on 6 March 2017.

Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan

PubMed Central

Teich, Jonathan M.; Osheroff, Jerome A.; Pifer, Eric A.; Sittig, Dean F.; Jenders, Robert A.

2005-01-01

Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption. PMID:15802474

A Chronic Disease Prevention and Management Corridor© to Supporting System-Level Transformations for Chronic Conditions.

PubMed

Sampalli, Tara; Christian, Erin; Edwards, Lynn; Ryer, Ashley

2015-01-01

Improving care for chronic conditions requires system-level transformations to ensure multiple levels of adoption and sustainability of the implemented improvements. These comprehensive solutions require transformations and supports at various levels, leadership and process changes at service/program level. Recognizing the importance of an organization-wide strategy to mitigate the growing issue of chronic disease prevention and management, a novel system-level approach has been developed in a district health authority in Nova Scotia, Canada. In this paper, the contextual factors and efforts that led to the conceptual framework of the Chronic Disease Prevention and Management (CDPM) "Corridor©" to management of chronic conditions are discussed. The CDPM Corridor© essentially constitutes a system-level redesign process; common elements, tools and resources; and a hub of supports for chronic disease prevention and management. The CDPM Corridor © will include a toolkit to guide the implementation of the proposed transformations.

Multiple Measures Accountability Systems: A Perspective from Vermont

ERIC Educational Resources Information Center

Fowler, Amy

2018-01-01

In response to Bae's (2018) "Redesigning systems of school accountability: A multiple measures approach to accountability and support," this commentary expands on some key considerations for states and school districts as they seek different ways to support school improvement while also addressing the competing demands of educators,…

The Impact of Positive Behavioral Interventions Supports on Ethnic Minority Students

ERIC Educational Resources Information Center

Flores, Yadira

2010-01-01

This study assessed the influence of the Positive Behavioral Interventions and Support (PBIS) discipline system on disciplinary referrals, (ODRs), suspensions, academic improvement and attendance in two rural schools. The influence of the PBIS system on the variables of interest was assessed for all students combined and subsequently between…

76 FR 34713 - Proposed Establishment of a Federally Funded Research and Development Center-Third Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... (FFRDC) to facilitate the modernization of business processes and supporting systems and their operations... processes and supporting systems and their operations. Some of the broad task areas that will be utilized..., organizational planning, research and development, continuous process improvement, Independent Verification and...

A decision-supported outpatient practice system.

PubMed Central

Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

1996-01-01

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

Useful Life Prediction for Payload Carrier Hardware

NASA Technical Reports Server (NTRS)

Ben-Arieh, David

2002-01-01

The Space Shuttle has been identified for use through 2020. Payload carrier systems will be needed to support missions through the same time frame. To support the future decision making process with reliable systems, it is necessary to analyze design integrity, identify possible sources of undesirable risk and recognize required upgrades for carrier systems. This project analyzed the information available regarding the carriers and developed the probability of becoming obsolete under different scenarios. In addition, this project resulted in a plan for an improved information system that will improve monitoring and control of the various carriers. The information collected throughout this project is presented in this report as process flow, historical records, and statistical analysis.

Family Support: Fostering Leadership and Partnership to Improve Access and Quality. Building State Early Childhood Comprehensive Systems Series, Number 14

ERIC Educational Resources Information Center

Thompson, Lisa; Uyeda, Kimberly

2004-01-01

The federal Maternal and Child Health Bureau (MCHB) has launched a five-year initiative that will support state efforts to build comprehensive early childhood service systems. This initiative--the State Early Childhood Comprehensive Systems (SECCS) Initiative--provides planning and implementation grants to the state and territory Maternal and…

Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.

PubMed

Hochgesang, Mindy; Zamudio-Haas, Sophia; Moran, Lissa; Nhampossa, Leopoldo; Packel, Laura; Leslie, Hannah; Richards, Janise; Shade, Starley B

2017-01-01

The rapid scale-up of HIV care and treatment in resource-limited countries requires concurrent, rapid development of health information systems to support quality service delivery. Mozambique, a country with an 11.5% prevalence of HIV, has developed nation-wide patient monitoring systems (PMS) with standardized reporting tools, utilized by all HIV treatment providers in paper or electronic form. Evaluation of the initial implementation of PMS can inform and strengthen future development as the country moves towards a harmonized, sustainable health information system. This assessment was conducted in order to 1) characterize data collection and reporting processes and PMS resources available and 2) provide evidence-based recommendations for harmonization and sustainability of PMS. This baseline assessment of PMS was conducted with eight non-governmental organizations that supported the Ministry of Health to provide 90% of HIV care and treatment in Mozambique. The study team conducted structured and semi-structured surveys at 18 health facilities located in all 11 provinces. Seventy-nine staff were interviewed. Deductive a priori analytic categories guided analysis. Health facilities have implemented paper and electronic monitoring systems with varying success. Where in use, robust electronic PMS facilitate facility-level reporting of required indicators; improve ability to identify patients lost to follow-up; and support facility and patient management. Challenges to implementation of monitoring systems include a lack of national guidelines and norms for patient level HIS, variable system implementation and functionality, and limited human and infrastructure resources to maximize system functionality and information use. This initial assessment supports the need for national guidelines to harmonize, expand, and strengthen HIV-related health information systems. Recommendations may benefit other countries with similar epidemiologic and resource-constrained environments seeking to improve PMS implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Force Measurement Improvements to the National Transonic Facility Sidewall Model Support System

NASA Technical Reports Server (NTRS)

Goodliff, Scott L.; Balakrishna, Sundareswara; Butler, David; Cagle, C. Mark; Chan, David; Jones, Gregory S.; Milholen, William E., II

2016-01-01

The National Transonic Facility is a transonic pressurized cryogenic facility. The development of the high Reynolds number semi-span capability has advanced over the years to include transonic active flow control and powered testing using the sidewall model support system. While this system can be used in total temperatures down to -250Â F for conventional unpowered configurations, it is limited to temperatures above -60Â F when used with powered models that require the use of the high-pressure air delivery system. Thermal instabilities and non-repeatable mechanical arrangements revealed several data quality shortfalls by the force and moment measurement system. Recent modifications to the balance cavity recirculation system have improved the temperature stability of the balance and metric model-to-balance hardware. Changes to the mechanical assembly of the high-pressure air delivery system, particularly hardware that interfaces directly with the model and balance, have improved the repeatability of the force and moment measurement system. Drag comparisons with the high-pressure air system removed will also be presented in this paper.

QRIS and Inclusion: Do State QRIS Standards Support the Learning Needs of All Children? CEELO FastFact

ERIC Educational Resources Information Center

Horowitz, Michelle; Squires, Jim

2014-01-01

As the country quickly builds its efforts to enhance quality in early education and care classrooms, states are implementing Quality Rating and Improvement Systems (QRIS) to recognize and improve the quality of programs. QRIS also provides technical support and increased financial benefits for participating programs to attain higher levels of…

Reporting Data with "Over-the-Counter" Data Analysis Supports Improves Educators' Data Analyses

ERIC Educational Resources Information Center

Rankin, Jenny Grant

2014-01-01

The benefits of making data-informed decisions to improve learning rely on educators correctly interpreting given data. Many educators routinely misinterpret data, even at districts with proactive support for data use. The tool most educators use for data analyses, which is an information technology data system or its reports, typically reports…

Critical interactions between Global Fund-supported programmes and health systems: a case study in Lao People's Democratic Republic.

PubMed

Mounier-Jack, Sandra; Rudge, James W; Phetsouvanh, Rattanaxay; Chanthapadith, Chansouk; Coker, Richard

2010-11-01

In Lao PDR, investment by the Global Fund to Fight AIDS, Tuberculosis and Malaria has played an important role in scaling up the response to HIV and tuberculosis (TB). As part of a series of case studies on how Global Fund-supported programmes interact with national health systems, we assessed the nature and extent of integration of the Global Fund portfolios within the national HIV and TB programmes, the integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support in Lao PDR. The study relied on a literature review and 35 interviews with key stakeholders using the Systemic Rapid Assessment Toolkit and thematic analysis. In Lao PDR, the HIV and TB programmes remain vertical and mostly weakly integrated with the general health system. However, Global Fund investments have extended the network of facilities delivering care at local level, resulting in greater integration with primary care and improved access for patients, particularly for TB. For HIV, as the prevalence remains low, services primarily target high-risk groups in urban areas. Less integrated functions include procurement and drug supply, and monitoring and evaluation. HIV and TB programmes are only starting to coordinate with each other. Global Fund-supported activities are generally integrated within the national disease programmes, except for monitoring and evaluation. Synergies of Global Fund support with the health system include improved access to services, institutional strengthening and capacity building, improved family planning (with wider condom distribution through HIV/AIDS social marketing programmes), and the delivery of add-on interventions, such as vaccinations and health education, alongside Global Fund-supported interventions at community level. Unintended consequences concern the lack of alignment between national stated priorities (maternal and child health) and the strong focus of external partners, such as the Global Fund, on financing communicable disease programmes.

Rotor vibration reduction with polymeric sectors

NASA Astrophysics Data System (ADS)

Dutt, J. K.; Toi, T.

2003-05-01

This work has been undertaken principally with an idea to improving the dynamic performance of rotor-shaft systems, which often suffer from two major problems (a) resonance and (b) loss of stability, resulting in excessive vibration of such systems. Polymeric material in the form of sectors has been considered in this work as bearing supports. Polymeric material has been considered in this work as both stiffness and loss factor of such materials varies with the frequency of excitation. Stiffness and loss factor have been found out for the proposed support system comprising of polymeric sectors. Depending upon the frequency of excitation the system matrix, in this case, changes and dynamic performance of the rotor-shaft system also changes accordingly. Here in this work avoidance of resonance and application of optimum damping in the support have been investigated by finding out the optimum dimension, i.e., the optimum thickness and optimum length of the sectors. It has been theoretically found that use of such sectors reduces the rotor unbalanced response, increases the stability limit speed for simple rotor-shaft systems and thus improves the dynamic characteristics. Parameters of the system have been presented in terms of non-dimensional quantities. Many examples have been presented in support of the conclusion. The life of such supports, particularly in the presence of chemicals and other reagents has not been investigated.

[Study on emission standard system of air pollutants].

PubMed

Jiang, Mei; Zhang, Guo-Ning; Zhang, Ming-Hui; Zou, Lan; Wei, Yu-Xia; Ren, Chun

2012-12-01

Scientific and reasonable emission standard system of air pollutants helps to systematically control air pollution, enhance the protection of the atmospheric environment effect and improve the overall atmospheric environment quality. Based on the study of development, situation and characteristics of national air pollutants emission standard system, the deficiencies of system were pointed out, which were not supportive, harmonious and perfect, and the improvement measures of emission standard system were suggested.

DISPLA: decision information system for procurement and logistics analysis

NASA Astrophysics Data System (ADS)

Calvo, Alberto B.; Danish, Alexander J.; Lamonakis, Gregory G.

2002-08-01

This paper describes an information-exchange system for Display systems acquisition and logistics support. DISPLA (Decision Information System for Procurement and Logistics Analysis) is an Internet-based system concept for bringing sellers (display system and component suppliers) and buyers (Government Program Offices and System Integrators) together in an electronic exchange to improve the acquisition and logistics analysis support of Flat Panel Displays for the military. A proof-of-concept demonstration is presented in this paper using sample data from vendor Web sites and Government data sources.

ECO-ITS : Intelligent Transportation System Applications to Improve Environmental Performance

DOT National Transportation Integrated Search

2012-05-01

This report describes recent research supported by the US DOTs AERIS program, building upon existing work through developing and improving data collection methods, developing new data fusion techniques to improve estimates, and applying appropriat...

Low Level Leaks

NASA Technical Reports Server (NTRS)

1998-01-01

NASA has transferred the improved portable leak detector technology to UE Systems, Inc.. This instrument was developed to detect leaks in fluid systems of critical launch and ground support equipment. This system incorporates innovative electronic circuitry, improved transducers, collecting horns, and contact sensors that provide a much higher degree of reliability, sensitivity and versatility over previously used systems. Potential commercial uses are pipelines, underground utilities, air-conditioning systems, petrochemical systems, aerospace, power transmission lines and medical devices.

Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria: Successes and Challenges.

PubMed

Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri

2016-01-01

Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.

The "I" in QRIS Survey: Collecting Data on Quality Improvement Activities for Early Childhood Education Programs. REL 2017-221

ERIC Educational Resources Information Center

Faria, Ann-Marie; Hawkinson, Laura; Metzger, Ivan; Bouacha, Nora; Cantave, Michelle

2017-01-01

A quality rating and improvement system (QRIS) is a voluntary state assessment system that uses multidimensional data on early childhood education programs to rate program quality, support quality improvement efforts, and provide information to families about the quality of available early childhood education programs. QRISs have two components:…

Can formal collaborative methodologies improve quality in primary health care in New Zealand? Insights from the EQUIPPED Auckland Collaborative.

PubMed

Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin

2012-12-01

Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.

Information Systems Education: The Case for the Academic Cloud

ERIC Educational Resources Information Center

Mew, Lionel

2016-01-01

This paper discusses how cloud computing can be leveraged to add value to academic programs in information systems and other fields by improving financial sustainment models for institutional technology and academic departments, relieving the strain on overworked technology support resources, while adding richness and improving pedagogical…

A systematic review of patient tracking systems for use in the pediatric emergency department.

PubMed

Dobson, Ian; Doan, Quynh; Hung, Geoffrey

2013-01-01

Patient safety is of great importance in the pediatric emergency department (PED). The combination of acutely and critically ill patients and high patient volumes creates a need for systems to support physicians in making accurate and timely diagnoses. Electronic patient tracking systems can potentially improve PED safety by reducing overcrowding and enhancing security. To enhance our understanding of current electronic tracking technologies, how they are implemented in a clinical setting, and resulting effect on patient care outcomes including patient safety. Nine databases were searched. Two independent reviewers identified articles that contained reference to patient tracking technologies in pediatrics or emergency medicine. Quantitative studies were assessed independently for methodological strength by two reviewers using an external assessment tool. Of 2292 initial articles, 22 were deemed relevant. Seventeen were qualitative, and the remaining five quantitative articles were assessed as being methodologically weak. Existing patient tracking systems in the ED included: infant monitoring/abduction prevention; barcode identification; radiofrequency identification (RFID)- or infrared (IR)-based patient tracking. Twenty articles supported the use of tracking technology to enhance patient safety or improve efficiency. One article failed to support the use of IR patient sensors due to study design flaws. Support exists for the use of barcode-, IR-, and RFID-based patient tracking systems to improve ED patient safety and efficiency. A lack of methodologically strong studies indicates a need for further evidence-based support for the implementation of patient tracking technology in a clinical or research setting. Copyright © 2013 Elsevier Inc. All rights reserved.

A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional

PubMed Central

Karsh, B‐T; Holden, R J; Alper, S J; Or, C K L

2006-01-01

The goal of improving patient safety has led to a number of paradigms for directing improvement efforts. The main paradigms to date have focused on reducing injuries, reducing errors, or improving evidence based practice. In this paper a human factors engineering paradigm is proposed that focuses on designing systems to improve the performance of healthcare professionals and to reduce hazards. Both goals are necessary, but neither is sufficient to improve safety. We suggest that the road to patient and employee safety runs through the healthcare professional who delivers care. To that end, several arguments are provided to show that designing healthcare delivery systems to support healthcare professional performance and hazard reduction should yield significant patient safety benefits. The concepts of human performance and hazard reduction are explained. PMID:17142611

Tracking and data system support for the Pioneer project. Volume 1: Pioneer 10-prelaunch planning through second trajectory correction, 4 December 1969 - 1 April 1972

NASA Technical Reports Server (NTRS)

Siegmeth, A. J.; Purdue, R. E.; Ryan, R. E.

1973-01-01

The tracking and data system support of the launch, near-earth, and deep space phases of the Pioneer 10 mission, which sent a Pioneer spacecraft into a flyby of Jupiter that would eventually allow the spacecraft to escape the solar system is discussed. The support through the spacecraft's second trajectory correction is reported. During this period, scientific instruments aboard the spacecraft registered information relative to interplanetary particles and fields, and radiometric data generated by the network continued to improve knowledge of the celestial mechanics of the solar system. In addition to network support activity detail, network performance and special support activities are covered.

The memory support system for mild cognitive impairment: randomized trial of a cognitive rehabilitation intervention.

PubMed

Greenaway, M C; Duncan, N L; Smith, G E

2013-04-01

Individuals with amnestic mild cognitive impairment (MCI) have few empirically based treatment options for combating their memory loss. This study sought to examine the efficacy of a calendar/notebook rehabilitation intervention, the memory support system (MSS), for individuals with amnestic MCI. Forty individuals with single domain amnestic MCI and their program partners were randomized to receive the MSS, either with training or without (controls). Measures of adherence, activities of daily living, and emotional impact were completed at the first and last intervention sessions and again at 8 weeks and 6 months post intervention. Training in use of a notebook/calendar system significantly improved adherence over those who received the calendars but no training. Functional ability and memory self-efficacy significantly improved for those who received MSS training. Change in functional ability remained significantly better in the intervention group than in the control group out to 8-week follow-up. Care partners in the intervention group demonstrated improved mood by 8-week and 6-month follow-ups, whereas control care partners reported worse caregiver burden by 6-month follow-up. Memory support system training resulted in improvement in activities of daily living and sense of memory self-efficacy for individuals with MCI. Although activities of daily living benefits were maintained out to 8 weeks post intervention, future inclusion of booster sessions may help extend the therapeutic effect out even further. Improved mood of care partners of trained individuals and worsening sense of caregiver burden over time for partners of untrained individuals further support the efficacy of the MSS for MCI. Copyright © 2012 John Wiley & Sons, Ltd.

7 CFR 1710.152 - Primary support documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... capital investments required to serve a borrower's planned new loads, improve service reliability and... manager to guide the system toward its financial goals. The forecast submitted in support of a loan...

The Health Quality and Safety Commission: making good health care better.

PubMed

Shuker, Carl; Bohm, Gillian; Bramley, Dale; Frost, Shelley; Galler, David; Hamblin, Richard; Henderson, Robert; Jansen, Peter; Martin, Geraint; Orsborn, Karen; Penny, Anthea; Wilson, Janice; Merry, Alan F

2015-01-30

New Zealand has one of the best value health care systems in the world, but as a proportion of GDP our spending on health care has increased every year since 1999. Further, there are issues of quality and safety in our system we must address, including rates of adverse events. The Health Quality and Safety Commission was formed in 2010 as a crown agent to influence, encourage, guide and support improvement in health care practice in New Zealand. The New Zealand Triple Aim has been defined as: improved quality, safety and experience of care; improved health and equity for all populations; and best value for public health system resources. The Commission is pursuing the Triple Aim via two fundamental objectives: doing the right thing by providing care supported by the best evidence available, focused on what matters to each individual patient, and doing the right thing right, first time, by making sure health care is safe and of the highest quality possible. Improvement efforts must be supported by robust but economical measurements. New Zealand has a strong culture of quality, so the Commission's role is to work with our colleagues to make good health care better.

A multimedia electronic patient record (ePR) system to improve decision support in pre- and rehabilitation through clinical and movement analysis

NASA Astrophysics Data System (ADS)

Liu, Brent; Documet, Jorge; McNitt-Gray, Sarah; Requejo, Phil; McNitt-Gray, Jill

2011-03-01

Clinical decisions for improving motor function in patients both with disability as well as improving an athlete's performance are made through clinical and movement analysis. Currently, this analysis facilitates identifying abnormalities in a patient's motor function for a large amount of neuro-musculoskeletal pathologies. However definitively identifying the underlying cause or long-term consequences of a specific abnormality in the patient's movement pattern is difficult since this requires information from multiple sources and formats across different times and currently relies on the experience and intuition of the expert clinician. In addition, this data must be persistent for longitudinal outcomes studies. Therefore a multimedia ePR system integrating imaging informatics data could have a significant impact on decision support within this clinical workflow. We present the design and architecture of such an ePR system as well as the data types that need integration in order to develop relevant decision support tools. Specifically, we will present two data model examples: 1) A performance improvement project involving volleyball athletes and 2) Wheelchair propulsion evaluation of patients with disabilities. The end result is a new frontier area of imaging informatics research within rehabilitation engineering and biomechanics.

Privacy-Preserving Patient-Centric Clinical Decision Support System on Naïve Bayesian Classification.

PubMed

Liu, Ximeng; Lu, Rongxing; Ma, Jianfeng; Chen, Le; Qin, Baodong

2016-03-01

Clinical decision support system, which uses advanced data mining techniques to help clinician make proper decisions, has received considerable attention recently. The advantages of clinical decision support system include not only improving diagnosis accuracy but also reducing diagnosis time. Specifically, with large amounts of clinical data generated everyday, naïve Bayesian classification can be utilized to excavate valuable information to improve a clinical decision support system. Although the clinical decision support system is quite promising, the flourish of the system still faces many challenges including information security and privacy concerns. In this paper, we propose a new privacy-preserving patient-centric clinical decision support system, which helps clinician complementary to diagnose the risk of patients' disease in a privacy-preserving way. In the proposed system, the past patients' historical data are stored in cloud and can be used to train the naïve Bayesian classifier without leaking any individual patient medical data, and then the trained classifier can be applied to compute the disease risk for new coming patients and also allow these patients to retrieve the top- k disease names according to their own preferences. Specifically, to protect the privacy of past patients' historical data, a new cryptographic tool called additive homomorphic proxy aggregation scheme is designed. Moreover, to leverage the leakage of naïve Bayesian classifier, we introduce a privacy-preserving top- k disease names retrieval protocol in our system. Detailed privacy analysis ensures that patient's information is private and will not be leaked out during the disease diagnosis phase. In addition, performance evaluation via extensive simulations also demonstrates that our system can efficiently calculate patient's disease risk with high accuracy in a privacy-preserving way.

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

76 FR 18224 - Announcement of Award

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... Improvement Center on the Representation of Children in the Child Welfare System (QIC-ChildRep). CFDA Number... of Children in the Child Welfare System (QIC-ChildRep), to support additional and enhanced evaluation...-ChildRep. The purpose of the QIC-ChildRep is to improve the quality of legal representation for children...

Improving Early Warning Systems with Categorized Course Resource Usage

ERIC Educational Resources Information Center

Waddington, R. Joseph; Nam, SungJin; Lonn, Steven; Teasley, Stephanie D.

2016-01-01

Early Warning Systems (EWSs) aggregate multiple sources of data to provide timely information to stakeholders about students in need of academic support. There is an increasing need to incorporate relevant data about student behaviors into the algorithms underlying EWSs to improve predictors of students' success or failure. Many EWSs currently…

A Model for System-Wide Collaboration to Support Integrated Social Behavior and Literacy Evidence-Based Practices

ERIC Educational Resources Information Center

Chaparro, Erin A.; Smolkowski, Keith; Baker, Scott K.; Hanson, Natalie; Ryan-Jackson, Kathleen

2012-01-01

In the face of dwindling financial resources, educational leaders are looking to refine resource allocation while maintaining a focus on improved student outcomes. This article presents initial findings from a professional development state initiative called Effective Behavioral and Instructional Support Systems (EBISS). The EBISS initiative aims…

Explicit Pre-Training Instruction Does Not Improve Implicit Perceptual-Motor Sequence Learning

ERIC Educational Resources Information Center

Sanchez, Daniel J.; Reber, Paul J.

2013-01-01

Memory systems theory argues for separate neural systems supporting implicit and explicit memory in the human brain. Neuropsychological studies support this dissociation, but empirical studies of cognitively healthy participants generally observe that both kinds of memory are acquired to at least some extent, even in implicit learning tasks. A key…

Language Development Support Systems: Project L.D.S.S. 1988-89. OREA Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Velasquez, Clara

Language Development Support Systems (Project LDSS) offered 215 limited English proficient (LEP) students at two New York City elementary schools the opportunity to improve their English skills through special language learning centers. These language learning centers were established at both schools and provided students with instruction in…

Evaluating Evaluation Systems: Policy Levers and Strategies for Studying Implementation of Educator Evaluation. Policy Snapshot

ERIC Educational Resources Information Center

Matlach, Lauren

2015-01-01

Evaluation studies can provide feedback on implementation, support continuous improvement, and increase understanding of evaluation systems' impact on teaching and learning. Despite the importance of educator evaluation studies, states often need support to prioritize and fund them. Successful studies require expertise, time, and a shared…

Towards public health decision support: a systematic review of bidirectional communication approaches.

PubMed

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-05-01

To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows.

Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

ERIC Educational Resources Information Center

Ballantine, R. Malcolm

Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

Hybrid Life Support System Technology Demonstrations

NASA Astrophysics Data System (ADS)

Morrow, R. C.; Wetzel, J. P.; Richter, R. C.

2018-02-01

Demonstration of plant-based hybrid life support technologies in deep space will validate the function of these technologies for long duration missions, such as Mars transit, while providing dietary variety to improve habitability.

A Decision-Support System for Sustainable Water Distribution System Planning.

PubMed

Freund, Alina; Aydin, Nazli Yonca; Zeckzer, Dirk; Hagen, Hans

2017-01-01

An interactive decision-support system (DSS) can help experts prepare water resource management plans for decision makers and stakeholders. The design of the proposed prototype incorporates visualization techniques such as circle views, grid layout, small multiple maps, and node simplification to improve the data readability of water distribution systems. A case study with three urban water management and sanitary engineering experts revealed that the proposed DSS is satisfactory, efficient, and effective.

Systems of Continuing Education: Priority to District Health Personnel. Report of a WHO Expert Committee. Technical Report Series 803.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

Continuing education systems can improve the performance of health workers in countries around the world and support the functioning of district health systems. Continuing education guides health personnel toward the principles and methods of primary health care and improves their work with the community and family to attain an adequate level of…

Decision support in psychiatry – a comparison between the diagnostic outcomes using a computerized decision support system versus manual diagnosis

PubMed Central

Bergman, Lars G; Fors, Uno GH

2008-01-01

Background Correct diagnosis in psychiatry may be improved by novel diagnostic procedures. Computerized Decision Support Systems (CDSS) are suggested to be able to improve diagnostic procedures, but some studies indicate possible problems. Therefore, it could be important to investigate CDSS systems with regard to their feasibility to improve diagnostic procedures as well as to save time. Methods This study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 to ascertain processing time and accuracy of diagnoses suggested. 63 clinicians volunteered to participate in the study and to solve two paper-based cases using either a CDSS or manually. Results No major difference between paper and pencil and computer-supported diagnosis was found. Where a difference was found it was in favour of paper and pencil. For example, a significantly shorter time was found for paper and pencil for the difficult case, as compared to computer support. A significantly higher number of correct diagnoses were found in the diffilt case for the diagnosis 'Depression' using the paper and pencil method. Although a majority of the clinicians found the computer method supportive and easy to use, it took a longer time and yielded fewer correct diagnoses than with paper and pencil. Conclusion This study could not detect any major difference in diagnostic outcome between traditional paper and pencil methods and computer support for psychiatric diagnosis. Where there were significant differences, traditional paper and pencil methods were better than the tested CDSS and thus we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy. A limitation was that most clinicians had not previously used the CDSS system under study. The results of this study, however, confirm that CDSS development for diagnostic purposes in psychiatry has much to deal with before it can be used for routine clinical purposes. PMID:18261222

Outcomes of HeartWare Ventricular Assist System support in 141 patients: a single-centre experience.

PubMed

Wu, Long; Weng, Yu-Guo; Dong, Nian-Guo; Krabatsch, Thomas; Stepanenko, Alexander; Hennig, Ewald; Hetzer, Roland

2013-07-01

A third-generation ventricular assist device, the HeartWare Ventricular Assist System, has demonstrated its reliability and durability in animal models and clinical experience. However, studies of a large series of applications are still lacking. We evaluate the safety and efficacy of the HeartWare pump in 141 patients with end-stage heart failure at a single centre. A total of 141 patients (116 men and 25 women with a mean age of 52 years) in New York Heart Association (NYHA) Class IV received implantation of the HeartWare Ventricular Assist System between August 2009 and April 2011 at the Deutsches Herzzentrum Berlin. The outcomes were measured in terms of laboratory data, adverse events, NYHA functional class and survival during device support. The HeartWare system provided an adequate haemodynamic support for patients both inside and outside the hospital. NYHA class improved to I-II. Organ function and pulmonary vascular resistance improved significantly. In this cohort of patients, 14 patients underwent heart transplantation, one had had the device explanted following myocardial recovery, one had changed to another assist device, 81 were on ongoing support and 44 died. The overall actuarial survival rates at 6 and 12 months were 70 and 67%, respectively, and the 3-, 6- and 12-month survival rates on a left ventricular assist device (LVAD) support for bridge to transplantation patients were 82, 81 and 79%, respectively. Infection and bleeding were the main adverse events. Four patients underwent an LVAD exchange for pump thrombosis. The HeartWare system provides a safe and effective circulatory support in a population with a wide range of body surface areas, with a satisfactory actuarial survival time and an improved quality of life. It can be used for univentricular or biventricular support, being implanted into the pericardial space with simplified surgical techniques.

Differences among Teachers' Perceptions of School Climate: Does Support for the Local Teacher Union Make a Difference?

ERIC Educational Resources Information Center

Griffith, Jason S.

2009-01-01

Although some school improvement literature has suggested that schools will improve when unions are removed from the school system, unions have rarely been isolated in the research. This study involved a mixed method case study approach to explore whether support of the local teacher union affected perceptions of school climate, as measured by the…

Applied Operations Research: Augmented Reality in an Industrial Environment

NASA Technical Reports Server (NTRS)

Cole, Stuart K.

2015-01-01

Augmented reality is the application of computer generated data or graphics onto a real world view. Its use provides the operator additional information or a heightened situational awareness. While advancements have been made in automation and diagnostics of high value critical equipment to improve readiness, reliability and maintenance, the need for assisting and support to Operations and Maintenance staff persists. AR can improve the human machine interface where computer capabilities maximize the human experience and analysis capabilities. NASA operates multiple facilities with complex ground based HVCE in support of national aerodynamics and space exploration, and the need exists to improve operational support and close a gap related to capability sustainment where key and experienced staff consistently rotate work assignments and reach their expiration of term of service. The initiation of an AR capability to augment and improve human abilities and training experience in the industrial environment requires planning and establishment of a goal and objectives for the systems and specific applications. This paper explored use of AR in support of Operation staff in real time operation of HVCE and its maintenance. The results identified include identification of specific goal and objectives, challenges related to availability and computer system infrastructure.

NASA's Plum Brook Station Water Systems

NASA Technical Reports Server (NTRS)

Puzak, Robert M.; Kimpton, Arthur

2006-01-01

Plum Brook Station's water systems were built in the 1940s to support a World War II ordnance production complex. Because the systems had not been analyzed for current NASA usage, it was unknown if they could meet current requirements and codes or if they were efficient for current use. NASA wanted to determine what improvements would be needed or advisable to support its research projects, so it contracted a hydraulic analysis of the raw and domestic water systems. Burgess and Niple determined current water demands and water flow, developed and calibrated models of the two water systems, and evaluated efficiency improvements and cost-cutting options. They recommended replacing some water mains, installing a new service connection, and removing some high-maintenance items (an underground reservoir, some booster pumps, and a tower).

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004-2012.

PubMed

Hamel, Donald J; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

From 2004-2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President's Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

Ikhana: A NASA Unmanned Aerial System Supporting Long-Duration Earth Science Missions

NASA Technical Reports Server (NTRS)

Cobleigh, Brent R.

2007-01-01

This viewgraph presentation reviews Ikhana's project goals: (1) Develop an airborne platform to conduct Earth observation and atmospheric sampling science missions both nationally and internationally, (2) develop and demonstrate technologies that improve the capability of UAVs to conduct science collection missions, (3) develop technologies that improve manned and unmanned aircraft systems, and (4) support important national UAV development activities. The criteria that guided the selection of the aircraft are listed. The payload areas on Ikhana are shown and the network that connects the systems are also reviewed. The data recorder is shown. Also the diagram of the Airborne Research Test System (ARTS) is reviewed. The Mobile Ground Control Station and the Mobile Ku SatCom Antenna are also shown and described.

Improving patient-level costing in the English and the German 'DRG' system.

PubMed

Vogl, Matthias

2013-03-01

The purpose of this paper is to develop ways to improve patient-level cost apportioning (PLCA) in the English and German inpatient 'DRG' cost accounting systems, to support regulators in improving costing schemes, and to give clinicians and hospital management sophisticated tools to measure and link their management. The paper analyzes and evaluates the PLCA step in the cost accounting schemes of both countries according to the impact on the key aspects of DRG introduction: transparency and efficiency. The goal is to generate a best available PLCA standard with enhanced accuracy and managerial relevance, the main requirements of cost accounting. A best available PLCA standard in 'DRG' cost accounting uses: (1) the cost-matrix from the German system; (2) a third axis in this matrix, representing service-lines or clinical pathways; (3) a scoring system for key cost drivers with the long-term objective of time-driven activity-based costing and (4) a point of delivery separation. Both systems have elements that the other system can learn from. By combining their strengths, regulators are supported in enhancing PLCA systems, improving the accuracy of national reimbursement and the managerial relevance of inpatient cost accounting systems, in order to reduce costs in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

SmartStaff: A Support Concept for Staff Planning

DTIC Science & Technology

2000-11-01

facilitated time management and decreased the ambiguities of the plans presented. However, the quality of the final plan did not improve. Team decision making, Team Planning, Group Support Systems, Task Group Staff

Scaling up Evidence-based Practices for Children and Families in New York State: Towards Evidence-based Policies on Implementation for State Mental Health Systems

PubMed Central

Hoagwood, Kimberly Eaton; Olin, S. Serene; Horwitz, Sarah; McKay, Mary; Cleek, Andrew; Gleacher, Alissa; Lewandowski, Eric; Nadeem, Erum; Acri, Mary; Chor, Ka Ho Brian; Kuppinger, Anne; Burton, Geraldine; Weiss, Dara; Frank, Samantha; Finnerty, Molly; Bradbury, Donna M.; Woodlock, Kristin M.; Hogan, Michael

2014-01-01

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems. PMID:24460518

Development and implementation of an expert system to improve the control of nitrification and denitrification in the Vic wastewater treatment plant.

PubMed

Ribas, F; Rodríguez-Roda, I; Serrat, J; Clara, P; Comas, J

2008-05-01

Wastewater treatment plants employ various physical, chemical and biological processes to reduce pollutants from raw wastewater. One of the most important is the biological nitrogen removal process through nitrification and denitrification steps taking place in various sections of the biological reactor. One of the most extensively used configurations to achieve the biological nitrogen removal is an activated sludge system using oxidation ditch or extended aeration. To improve nitrogen removal in the wastewater treatment plant (WWTP) of Vic (Catalonia, NE Spain), the automatic aeration control system was complemented with an Expert System to always provide the most appropriate aeration or anoxia sequence based on the values of ammonium and nitrates given by an automatic analyzer. This article illustrates the development and implementation of this knowledge-based system within the framework of a Decision Support System, which performs SCADA functions. The paper also shows that the application of the decision support system in the Vic WWTP resulted in significant improvements to the biological nitrogen removal.

How to improve vital sign data quality for use in clinical decision support systems? A qualitative study in nine Swedish emergency departments.

PubMed

Skyttberg, Niclas; Vicente, Joana; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2016-06-04

Vital sign data are important for clinical decision making in emergency care. Clinical Decision Support Systems (CDSS) have been advocated to increase patient safety and quality of care. However, the efficiency of CDSS depends on the quality of the underlying vital sign data. Therefore, possible factors affecting vital sign data quality need to be understood. This study aims to explore the factors affecting vital sign data quality in Swedish emergency departments and to determine in how far clinicians perceive vital sign data to be fit for use in clinical decision support systems. A further aim of the study is to provide recommendations on how to improve vital sign data quality in emergency departments. Semi-structured interviews were conducted with sixteen physicians and nurses from nine hospitals and vital sign documentation templates were collected and analysed. Follow-up interviews and process observations were done at three of the hospitals to verify the results. Content analysis with constant comparison of the data was used to analyse and categorize the collected data. Factors related to care process and information technology were perceived to affect vital sign data quality. Despite electronic health records (EHRs) being available in all hospitals, these were not always used for vital sign documentation. Only four out of nine sites had a completely digitalized vital sign documentation flow and paper-based triage records were perceived to provide a better mobile workflow support than EHRs. Observed documentation practices resulted in low currency, completeness, and interoperability of the vital signs. To improve vital sign data quality, we propose to standardize the care process, improve the digital documentation support, provide workflow support, ensure interoperability and perform quality control. Vital sign data quality in Swedish emergency departments is currently not fit for use by CDSS. To address both technical and organisational challenges, we propose five steps for vital sign data quality improvement to be implemented in emergency care settings.

Drivers' safety needs, behavioural adaptations and acceptance of new driving support systems.

PubMed

Saad, Farida; Van Elslande, Pierre

2012-01-01

The aim of this paper is to discuss the contribution of two complementary approaches for designing and evaluating new driver support systems likely to improve the operation and safety of the road traffic system. The first approach is based on detailed analyses of traffic crashes so as to estimate drivers' needs for assistance and the situational constraints that safety functions should address to be efficient. The second approach is based on in depth-analyses of behavioral adaptations induced by the usage of new driver support systems in regular driving situations and on drivers' acceptance of the assistance provided by the systems.

Framework for the Intelligent Transportation System (ITS) Evaluation : ITS Integration Activities

DOT National Transportation Integrated Search

2006-08-01

Intelligent Transportation Systems (ITS) represent a significant opportunity to improve the efficiency and safety of the surface transportation system. ITS includes technologies to support information processing, communications, surveillance and cont...

Information support for health information management in regional Sri Lanka: health managers' perspectives.

PubMed

Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka.

SMSaúde: Design, Development, and Implementation of a Remote/Mobile Patient Management System to Improve Retention in Care for HIV/AIDS and Tuberculosis Patients.

PubMed

Nhavoto, José António; Grönlund, Åke; Chaquilla, Walter Ponce

2015-03-09

The widespread and low cost of mobile phones and the convenience of short message service (SMS) text messaging suggest potential suitability for use with alternative strategies for supporting retention in care and adherence to the treatment of various chronic diseases, such as HIV and tuberculosis (TB). Despite the growing body of literature reporting positive outcomes of SMS text message-based communication with patients, there is yet very little research about the integration of communication technologies and electronic medical records or electronic patient tracking systems. To design, develop, and implement an integrated mobile phone text messaging system used to follow up with patients with HIV and TB in treatment in Mozambique. Following the design science research methodology, we developed a Web-based system that provides support to patients. A case study involving three health care sites in Mozambique was a basis for discussing design issues for this kind of system. We used brainstorming techniques to solicit usability requirements, focus group meetings to discuss and define system architecture, and prototyping to test in real environments and to improve the system. We found six sets of system requirements that need to be addressed for success: data collection, telecommunication costs, privacy and data security, text message content, connectivity, and system scalability. A text messaging system was designed and implemented in three health facilities. These sites feed data into a central data repository, which can be used for analysis of operations and decision support. Based on the treatment schedule, the system automatically sent SMS text message appointment reminders, medication reminders, as well as motivational and educational messages to patients enrolled in antiretroviral therapy and TB treatment programs. We successfully defined the requirements for, designed, and implemented a mobile phone text messaging system to support HIV and TB treatments. Implementation of this system could improve patients' self-management skills and strengthen communication between patients and health care providers.

A 1-D Model of the 4 Bed Molecular Sieve of the Carbon Dioxide Removal Assembly

NASA Technical Reports Server (NTRS)

Coker, Robert; Knox, Jim

2015-01-01

Developments to improve system efficiency and reliability for water and carbon dioxide separation systems on crewed vehicles combine sub-scale systems testing and multi-physics simulations. This paper describes the development of COMSOL simulations in support of the Life Support Systems (LSS) project within NASA's Advanced Exploration Systems (AES) program. Specifically, we model the 4 Bed Molecular Sieve (4BMS) of the Carbon Dioxide Removal Assembly (CDRA) operating on the International Space Station (ISS).

Ergonomics action research II: a framework for integrating HF into work system design.

PubMed

Neumann, W P; Village, J

2012-01-01

This paper presents a conceptual framework that can support efforts to integrate human factors (HF) into the work system design process, where improved and cost-effective application of HF is possible. The framework advocates strategies of broad stakeholder participation, linking of performance and health goals, and process focussed change tools that can help practitioners engage in improvements to embed HF into a firm's work system design process. Recommended tools include business process mapping of the design process, implementing design criteria, using cognitive mapping to connect to managers' strategic goals, tactical use of training and adopting virtual HF (VHF) tools to support the integration effort. Consistent with organisational change research, the framework provides guidance but does not suggest a strict set of steps. This allows more adaptability for the practitioner who must navigate within a particular organisational context to secure support for embedding HF into the design process for improved operator wellbeing and system performance. There has been little scientific literature about how a practitioner might integrate HF into a company's work system design process. This paper proposes a framework for this effort by presenting a coherent conceptual framework, process tools, design tools and procedural advice that can be adapted for a target organisation.

Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda.

PubMed

Iyer, Hari S; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R; Drobac, Peter C

2015-01-01

While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level.

Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda

PubMed Central

Iyer, Hari S.; Kamanzi, Emmanuel; Mugunga, Jean Claude; Finnegan, Karen; Uwingabiye, Alice; Shyaka, Edward; Niyonzima, Saleh; Hirschhorn, Lisa R.; Drobac, Peter C.

2015-01-01

Background While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda. Design The partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach. Results We found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline. Conclusions Rapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level. PMID:26140729

The Roles of Social Support and Health Literacy in Self-Management Among Patients With Chronic Kidney Disease.

PubMed

Chen, Yu-Chi; Chang, Li-Chun; Liu, Chieh-Yu; Ho, Ya-Fang; Weng, Shuo-Chun; Tsai, Tzu-I

2018-05-01

To investigate the relationships among social support, health literacy, and self-management, and the factors influencing self-management of chronic kidney disease (CKD). Cross-sectional study. A random sample of 410 patients was recruited from nephrology clinics. Data were collected using structured questionnaires and chart reviews from January 2013 to February 2014. Hierarchical regression analysis was used to determine the predictive factors of self-management behaviors and ∆R 2 to determine each variable's explanatory power. Health literacy and social support were positively correlated with self-management behaviors. Furthermore, social support, health literacy, and marital status were significant predictors of self-management behaviors. Social support had a relatively greater explanatory power for self-management behaviors than did health literacy. Particularly, healthcare provider support had the greatest influence on patients' self-management behaviors. Health literacy and social support play independent positive roles in self-management behaviors of patients with CKD, with social support having a particularly dominant role. Further research using a systems approach to improving self-management behaviors is necessary to clarify the role of social support. Health literacy and social support are independently and positively related to self-management. Social support, which is a system-level factor, is a relatively stronger and crucial predictor than is health literacy. Nurses have to refine self-management programs to focus on families and adopt a systems approach to help CKD patients improve their self-management behaviors. © 2018 Sigma Theta Tau International.

Assessment of System Frequency Support Effect of PMSG-WTG Using Torque-Limit-Based Inertial Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Xiao; Gao, Wenzhong; Wang, Jianhui

2017-02-16

To release the 'hidden inertia' of variable-speed wind turbines for temporary frequency support, a method of torque-limit based inertial control is proposed in this paper. This method aims to improve the frequency support capability considering the maximum torque restriction of a permanent magnet synchronous generator. The advantages of the proposed method are improved frequency nadir (FN) in the event of an under-frequency disturbance; and avoidance of over-deceleration and a second frequency dip during the inertial response. The system frequency response is different, with different slope values in the power-speed plane when the inertial response is performed. The proposed method ismore » evaluated in a modified three-machine, nine-bus system. The simulation results show that there is a trade-off between the recovery time and FN, such that a gradual slope tends to improve the FN and restrict the rate of change of frequency aggressively while causing an extension of the recovery time. These results provide insight into how to properly design such kinds of inertial control strategies for practical applications.« less

Tracking and data system support for the pioneer project. Volume 11 Pioneers 6-9. Extended missions: 1 July 1971 - 1 July 1973

NASA Technical Reports Server (NTRS)

Renzetti, N. A.; Siegmeth, A. J.

1973-01-01

The Tracking and Data System supported the deep space phases of the Pioneer 6, 7, 8, and 9 missions, with two spacecraft in an inward trajectory and two spacecraft in an outward trajectory from the earth in heliocentric orbits. Scientific instruments aboard each of the spacecraft continued to register information relative to interplanetary particles and fields, and radio metric data generated by the network continued to improve our knowledge of the celestial mechanics of the solar system. In addition to network support activity detail, network performance and special support activities are covered.

An affordable, computerised, table-based exercise system for stroke survivors.

PubMed

King, Marcus; Hale, Leigh; Pekkari, Anna; Persson, Martin; Gregorsson, Malin; Nilsson, Mikaela

2010-07-01

Loss of hand function as a result of upper limb paresis after a stroke leads to reduced independence. Robotic-assisted therapy with virtual reality leads to improvements in motor function, but there is a need to improve the cost-benefit ratio of these therapies. This case series study investigated augmented reality computer games which provided a rewarded, goal-directed task to upper limb rehabilitation via a gravity supported reaching task. A computer game was developed to motivate chronic stroke survivors to undertake gravity supported reaching tasks performed on a table, and a focus group study investigated the application of this device for rehabilitation. From the focus group, a simple device was developed to improve the quality of the exercise and a further focus group study investigated a variety of computer games to determine motivations for undertaking rehabilitation exercises. Of the four participants in the case study, two showed improvement in ability to play the game and in arm function. Participants enjoyed playing a range of computer games and felt that the system provided a worthwhile exercise. Motivation for undertaking exercise with the system included: intellectual stimulation during game play, feedback such as game score, gaining physical benefits from the exercise, the system tolerating varying levels of disability, ability to relate to the game and ability to use the system in social groups. A low-cost device has been developed which increases the exercise of gravity supported reaching movements, provides goal-directed tasks with rewards and motivates the user to undertake extended rehabilitation.

Satellite irrigation management support with the terrestrial observation and prediction system: A framework for integration of satellite & surface observations to support improvements in agricultural water resource management

USDA-ARS?s Scientific Manuscript database

In California and other regions vulnerable to water shortages, satellite-derived estimates of key hydrologic parameters can support agricultural producers and water managers in maximizing the benefits of available water supplies. The Satellite Irrigation Management Support (SIMS) project combines N...

Supporting Parents and Children Where They Live: Improving Federal and State Policy for Home Visiting

ERIC Educational Resources Information Center

DiLauro, Elizabeth

2010-01-01

As part of a comprehensive system of support for families with young children, home visiting programs help to ensure that families facing obstacles--such as those caused by stress, language barriers, geographic and social isolation, and poverty--receive the support they need to nurture their child's healthy development. Efforts to support home…

Human-Centered Systems Analysis of Aircraft Separation from Adverse Weather: Implications for Icing Remote Sensing

NASA Technical Reports Server (NTRS)

Vigeant-Langlois, Laurence; Hansman, R. John, Jr.

2003-01-01

The objective of this project was to propose a means to improve aviation weather information, training procedures based on a human-centered systems approach. Methodology: cognitive analysis of pilot's tasks; trajectory-based approach to weather information; contingency planning support; and implications for improving weather information.

South Carolina Case Study: Building a Student-Level Longitudinal Data System

ERIC Educational Resources Information Center

Kugle, Cherry; Smith, Nancy

2007-01-01

The Data Quality Campaign is a national, collaborative effort to encourage and support state policymakers to improve the collection, availability and use of high-quality education data and to implement state longitudinal data systems to improve student achievement. The campaign aims to provide tools and resources that will assist state development…

76 FR 64174 - Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... examples, supporting any opinions or conclusions; (2) approaches and options toward improvement or... out such approaches or options. FOR FURTHER INFORMATION CONTACT: Federal Insurance Office, Department... submit views on: 1. Systemic risk regulation with respect to insurance; 2. Capital standards and the...

GPE 2020: Improving Learning and Equity through Stronger Education Systems. Strategic Plan 2016-2020

ERIC Educational Resources Information Center

Global Partnership for Education, 2016

2016-01-01

The Global Partnership for Education (GPE) addresses the most significant education challenges faced by developing countries through supporting governments to improve equity and learning by strengthening their education systems. GPE is a global fund and a partnership focused entirely on education in developing countries. The partnership has a…

Louisiana Case Study: Building a Student-Level Longitudinal Data System

ERIC Educational Resources Information Center

Kugle, Cherry; Smith, Nancy

2008-01-01

The Data Quality Campaign is a national, collaborative effort to encourage and support state policymakers to improve the collection, availability and use of high-quality education data and to implement state longitudinal data systems to improve student achievement. The campaign aims to provide tools and resources that will assist state development…

Quality Rating and Improvement Systems and Children's Cognitive Development

ERIC Educational Resources Information Center

Jeon, Lieny; Buettner, Cynthia K.

2015-01-01

Background: Providing enriched learning environments is important to stimulating children's development in early childhood. Early child-care policymakers in many states in the US have adopted Quality Rating and Improvement Systems (QRIS) as a way to verify quality of child care and to support children's school readiness. Objective: The purpose of…

Educational Management and Information

ERIC Educational Resources Information Center

Schaulis, Robert E.; Gripp, Thomas H.

1974-01-01

Improvement of information systems to support management and planning in education is dependent on a change to a rational management style. It can be argued that this same prerequisite exists for the return of public confidence and support. (Author)

Use of Self-Monitoring to Maintain Program Fidelity of Multi-Tiered Interventions

ERIC Educational Resources Information Center

Nelson, J. Ron; Oliver, Regina M.; Hebert, Michael A.; Bohaty, Janet

2015-01-01

Multi-tiered system of supports represents one of the most significant advancements in improving the outcomes of students for whom typical instruction is not effective. While many practices need to be in place to make multi-tiered systems of support effective, accurate implementation of evidence-based practices by individuals at all tiers is…

The Utilization of a Clinical Decision Support System to Manage Adult Type 2 Diabetes: A Correlational Study

ERIC Educational Resources Information Center

Faught, I. Charie

2012-01-01

While the Institute of Medicine (2001) has promoted health information technology to improve the process of care such as compliance with clinical practice guidelines and quicker access to clinical information, diagnostic tests, and treatment results, very little was known about how a clinical decision support system can contribute to diabetes…

Learning-Focused Leadership and Leadership Support: Meaning and Practice in Urban Systems

ERIC Educational Resources Information Center

Knapp, Michael S.; Copland, Michael A.; Honig, Meredith I.; Plecki, Margaret L.; Portin, Bradley S.

2010-01-01

This report synthesizes what has been learned about how leaders in urban systems focus their leadership on the improvement of learning, and what it takes to support their leadership in these settings. The report brings together findings from three sub-study strands, concerned with efforts in seven urban districts to: a) invest staffing and other…

Managing Performance in the System of Support: Rubric with 52 Indicators, Explanations, and Exemplars

ERIC Educational Resources Information Center

Hanes, Susan; Kerins, Thomas; Perlman, Carole; Redding, Sam; Ross, Steven

2013-01-01

The Building State Capacity and Productivity (BSCP) Center released a report outlining a process for state education agencies (SEAs) to evaluate and improve their System of Recognition, Accountability, and Support (SRAS). The federal government now sets high expectations for state and local use of federal dollars while allowing greater state…

iSTART Therefore I Understand: But Metacognitive Supports Did Not Enhance Comprehension Gains

ERIC Educational Resources Information Center

McCarthy, Kathryn S.; Jacovina, Matthew E.; Snow, Erica L.; Guerrero, Tricia A.; McNamara, Danielle S.

2017-01-01

iSTART is an intelligent tutoring system designed to provide self-explanation instruction and practice to improve students' comprehension of complex, challenging text. This study examined the effects of extended game-based practice within the system as well as the effects of two metacognitive supports implemented within this practice. High school…

Improving Emergency Department Triage Classification with Computerized Clinical Decision Support at a Pediatric Hospital

ERIC Educational Resources Information Center

Kunisch, Joseph Martin

2012-01-01

Background: The Emergency Severity Index (ESI) is an emergency department (ED) triage classification system based on estimated patient-specific resource utilization. Rules for a computerized clinical decision support (CDS) system based on a patient's chief complaint were developed and tested using a stochastic model for predicting ESI scores.…

Development of a decision support system for monitoring, reporting and forecasting ecological conditions of the Appalachian Trail

USGS Publications Warehouse

Wang, Yeqiao; Nemani, Ramakrishna; Dieffenbach, Fred; Stolte, Kenneth; Holcomb, Glenn B.; Robinson, Matt; Reese, Casey C.; McNiff, Marcia; Duhaime, Roland; Tierney, Geri; Mitchell, Brian; August, Peter; Paton, Peter; LaBash, Charles

2010-01-01

This paper introduces a collaborative multi-agency effort to develop an Appalachian Trail (A.T.) MEGA-Transect Decision Support System (DSS) for monitoring, reporting and forecasting ecological conditions of the A.T. and the surrounding lands. The project is to improve decisionmaking on management of the A.T. by providing a coherent framework for data integration, status reporting and trend analysis. The A.T. MEGA-Transect DSS is to integrate NASA multi-platform sensor data and modeling through the Terrestrial Observation and Prediction System (TOPS) and in situ measurements from A.T. MEGA-Transect partners to address identified natural resource priorities and improve resource management decisions.

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Environmental Control and Life Support (ECLS) Integrated Roadmap Development

NASA Technical Reports Server (NTRS)

Metcalf, Jordan L.; Carrasquillo, Robyn; Bagdigian, Bob; Peterson, Laurie

2011-01-01

This white paper documents a roadmap for development of Environmental Control and Life Support (ECLS) Systems (ECLSS) capabilities required to enable beyond-Low Earth Orbit (LEO) Exploration missions. In many cases, the execution of this Exploration-based roadmap will directly benefit International Space Station (ISS) operational capability by resolving known issues and/or improving overall system reliability. In addition, many of the resulting products will be applicable across multiple Exploration elements such as Multi-Purpose Crew Vehicle (MPCV), Multi-Mission Space Exploration Vehicle (MMSEV), Deep Space Habitat (DSH), and Landers. Within the ECLS community, this white paper will be a unifying tool that will improve coordination of resources, common hardware, and technologies. It will help to align efforts to focus on the highest priority needs that will produce life support systems for future human exploration missions that will simply run in the background, requiring minimal crew interaction.

Evolution of International Space Station Program Safety Review Processes and Tools

NASA Technical Reports Server (NTRS)

Ratterman, Christian D.; Green, Collin; Guibert, Matt R.; McCracken, Kristle I.; Sang, Anthony C.; Sharpe, Matthew D.; Tollinger, Irene V.

2013-01-01

The International Space Station Program at NASA is constantly seeking to improve the processes and systems that support safe space operations. To that end, the ISS Program decided to upgrade their Safety and Hazard data systems with 3 goals: make safety and hazard data more accessible; better support the interconnection of different types of safety data; and increase the efficiency (and compliance) of safety-related processes. These goals are accomplished by moving data into a web-based structured data system that includes strong process support and supports integration with other information systems. Along with the data systems, ISS is evolving its submission requirements and safety process requirements to support the improved model. In contrast to existing operations (where paper processes and electronic file repositories are used for safety data management) the web-based solution provides the program with dramatically faster access to records, the ability to search for and reference specific data within records, reduced workload for hazard updates and approval, and process support including digital signatures and controlled record workflow. In addition, integration with other key data systems provides assistance with assessments of flight readiness, more efficient review and approval of operational controls and better tracking of international safety certifications. This approach will also provide new opportunities to streamline the sharing of data with ISS international partners while maintaining compliance with applicable laws and respecting restrictions on proprietary data. One goal of this paper is to outline the approach taken by the ISS Progrm to determine requirements for the new system and to devise a practical and efficient implementation strategy. From conception through implementation, ISS and NASA partners utilized a user-centered software development approach focused on user research and iterative design methods. The user-centered approach used on the new ISS hazard system utilized focused user research and iterative design methods employed by the Human Computer Interaction Group at NASA Ames Research Center. Particularly, the approach emphasized the reduction of workload associated with document and data management activities so more resources can be allocated to the operational use of data in problem solving, safety analysis, and recurrence control. The methods and techniques used to understand existing processes and systems, to recognize opportunities for improvement, and to design and review improvements are described with the intent that similar techniques can be employed elsewhere in safety operations. A second goal of this paper is to provide and overview of the web-based data system implemented by ISS. The software selected for the ISS hazard systemMission Assurance System (MAS)is a NASA-customized vairant of the open source software project Bugzilla. The origin and history of MAS as a NASA software project and the rationale for (and advantages of) using open-source software are documented elsewhere (Green, et al., 2009).

Examining the Premises Supporting the Empirically Supported Intervention Approach to Social Work Practice

ERIC Educational Resources Information Center

McBeath, Bowen; Briggs, Harold E.; Aisenberg, Eugene

2010-01-01

Federal, state, and local policymakers and funders have increasingly organized human service delivery functions around the selection and implementation of empirically supported interventions (ESIs), under the expectation that service delivery through such intervention frameworks results in improvements in cost-effectiveness and system performance.…

Improvements to Autoplot's HAPI Support

NASA Astrophysics Data System (ADS)

Faden, J.; Vandegriff, J. D.; Weigel, R. S.

2017-12-01

Autoplot handles data from a variety of data servers. These servers communicate data in different forms, each somewhat different in capabilities and each needing new software to interface. The Heliophysics Application Programmer's Interface (HAPI) attempts to ease this by providing a standard target for clients and servers to meet. Autoplot fully supports reading data from HAPI servers, and support continues to improve as the HAPI server spec matures. This collaboration has already produced robust clients and documentation which would be expensive for groups creating their own protocol. For example, client-side data caching is introduced where Autoplot maintains a cache of data for performance and off-line use. This is a feature we considered for previous data systems, but we could never afford the time to study and implement this carefully. Also, Autoplot itself can be used as a server, making the data it can read and the results of its processing available to other data systems. Autoplot use with other data transmission systems is reviewed as well, outlining features of each system.

Building an Evidence-Driven Child Welfare Workforce: A University–Agency Partnership

PubMed Central

Lery, Bridgette; Wiegmann, Wendy; Berrick, Jill Duerr

2016-01-01

The federal government increasingly expects child welfare systems to be more responsive to the needs of their local populations, connect strategies to results, and use continuous quality improvement (CQI) to accomplish these goals. A method for improving decision making, CQI relies on an inflow of high-quality data, up-to-date research evidence, and a robust organizational structure and climate that supports the deliberate use of evidence for decision making. This article describes an effort to build and support these essential system components through one public-private child welfare agency–university partnership. PMID:27429534

US FDA perspective on regulatory issues affecting circulatory assist devices.

PubMed

Sapirstein, Wolf; Chen, Eric; Swain, Julie; Zuckerman, Bram

2006-11-01

There has been a rapid development in mechanical circulatory support systems in the decade since the US FDA first approved a mechanical device to provide the circulatory support lacking from a failing heart. Devices are presently approved for marketing by the FDA to replace a failing ventricle, the Ventricular Assist Device or the entire heart, Total Artificial Heart. Contemporaneous with, and permitted by, improvement in technology and design, devices have evolved from units located extracorporeally to paracorporeal systems and totally implanted devices. Clinical studies have demonstrated a parallel improvement in the homeostatic adequacy of the circulatory support provided. Thus, while the circulatory support was initially tolerated for short periods to permit recovery of cardiac function, this technology eventually provided effective circulatory support for increasing periods that permitted the FDA to approve devices for bridging patients in end-stage cardiac failure awaiting transplant and eventually a device for destination therapy where patients in end-stage heart failure are not cardiac transplant candidates. The approved devices have relied on displacement pumps that mimic the pulsatility of the physiological system. Accelerated development of more compact devices that rely on alternative pump mechanisms have challenged both the FDA and device manufacturers to assure that the regulatory requirements for safety and effectiveness are met for use of mechanical circulatory support systems in expanded target populations. An FDA regulatory perspective is reviewed of what can be a potentially critical healthcare issue.

Technical assessment of Mir-1 life support hardware for the international space station

NASA Technical Reports Server (NTRS)

Mitchell, K. L.; Bagdigian, R. M.; Carrasquillo, R. L.; Carter, D. L.; Franks, G. D.; Holder, D. W., Jr.; Hutchens, C. F.; Ogle, K. Y.; Perry, J. L.; Ray, C. D.

1994-01-01

NASA has been progressively learning the design and performance of the Russian life support systems utilized in their Mir space station. In 1992, a plan was implemented to assess the benefits of the Mir-1 life support systems to the Freedom program. Three primary tasks focused on: evaluating the operational Mir-1 support technologies and understanding if specific Russian systems could be directly utilized on the American space station and if Russian technology design information could prove useful in improving the current design of the planned American life support equipment; evaluating the ongoing Russian life support technology development activities to determine areas of potential long-term application to the U.S. space station; and utilizing the expertise of their space station life support systems to evaluate the benefits to the current U.S. space station program which included the integration of the Russian Mir-1 designs with the U.S. designs to support a crew of six.

From assessment to improvement of elderly care in general practice using decision support to increase adherence to ACOVE quality indicators: study protocol for randomized control trial

PubMed Central

2014-01-01

Background Previous efforts such as Assessing Care of Vulnerable Elders (ACOVE) provide quality indicators for assessing the care of elderly patients, but thus far little has been done to leverage this knowledge to improve care for these patients. We describe a clinical decision support system to improve general practitioner (GP) adherence to ACOVE quality indicators and a protocol for investigating impact on GPs’ adherence to the rules. Design We propose two randomized controlled trials among a group of Dutch GP teams on adherence to ACOVE quality indicators. In both trials a clinical decision support system provides un-intrusive feedback appearing as a color-coded, dynamically updated, list of items needing attention. The first trial pertains to real-time automatically verifiable rules. The second trial concerns non-automatically verifiable rules (adherence cannot be established by the clinical decision support system itself, but the GPs report whether they will adhere to the rules). In both trials we will randomize teams of GPs caring for the same patients into two groups, A and B. For the automatically verifiable rules, group A GPs receive support only for a specific inter-related subset of rules, and group B GPs receive support only for the remainder of the rules. For non-automatically verifiable rules, group A GPs receive feedback framed as actions with positive consequences, and group B GPs receive feedback framed as inaction with negative consequences. GPs indicate whether they adhere to non-automatically verifiable rules. In both trials, the main outcome measure is mean adherence, automatically derived or self-reported, to the rules. Discussion We relied on active end-user involvement in selecting the rules to support, and on a model for providing feedback displayed as color-coded real-time messages concerning the patient visiting the GP at that time, without interrupting the GP’s workflow with pop-ups. While these aspects are believed to increase clinical decision support system acceptance and its impact on adherence to the selected clinical rules, systems with these properties have not yet been evaluated. Trial registration Controlled Trials NTR3566 PMID:24642339

Improvement of sand filter and constructed wetland design using an environmental decision support system.

PubMed

Turon, Clàudia; Comas, Joaquim; Torrens, Antonina; Molle, Pascal; Poch, Manel

2008-01-01

With the aim of improving effluent quality of waste stabilization ponds, different designs of vertical flow constructed wetlands and intermittent sand filters were tested on an experimental full-scale plant within the framework of a European project. The information extracted from this study was completed and updated with heuristic and bibliographic knowledge. The data and knowledge acquired were difficult to integrate into mathematical models because they involve qualitative information and expert reasoning. Therefore, it was decided to develop an environmental decision support system (EDSS-Filter-Design) as a tool to integrate mathematical models and knowledge-based techniques. This paper describes the development of this support tool, emphasizing the collection of data and knowledge and representation of this information by means of mathematical equations and a rule-based system. The developed support tool provides the main design characteristics of filters: (i) required surface, (ii) media type, and (iii) media depth. These design recommendations are based on wastewater characteristics, applied load, and required treatment level data provided by the user. The results of the EDSS-Filter-Design provide appropriate and useful information and guidelines on how to design filters, according to the expert criteria. The encapsulation of the information into a decision support system reduces the design period and provides a feasible, reasoned, and positively evaluated proposal.

Design challenges for electronic medication administration record systems in residential aged care facilities: a formative evaluation.

PubMed

Tariq, A; Lehnbom, E; Oliver, K; Georgiou, A; Rowe, C; Osmond, T; Westbrook, J

2014-01-01

Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues. We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

Design Challenges for Electronic Medication Administration Record Systems in Residential Aged Care Facilities

PubMed Central

Lehnbom, E.; Oliver, K.; Georgiou, A.; Rowe, C.; Osmond, T.; Westbrook, J.

2014-01-01

Summary Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues. We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use. PMID:25589911

Cobalt Fischer-Tropsch catalysts having improved selectivity

DOEpatents

Miller, James G.; Rabo, Jule A.

1989-01-01

A cobalt Fischer-Tropsch catalyst having an improved steam treated, acid extracted LZ-210 support is taught. The new catalyst system demonstrates improved product selectivity at Fischer-Tropsch reaction conditions evidenced by lower methane production, higher C.sub.5.sup.+ yield and increased olefin production.

A shared computer-based problem-oriented patient record for the primary care team.

PubMed

Linnarsson, R; Nordgren, K

1995-01-01

1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a primary care area with 30,000 inhabitants. It is being used by all the primary care team members: 15 general practitioners, 25 district nurses, and 10 physiotherapists. Several years of practical experience of the CPR system shows that it has a positive impact on quality of care on four levels: 1) improved clinical follow-up of individual patients; 2) facilitated follow-up of aggregated data such as practice activity analysis, annual reports, and clinical indicators; 3) automated medical audit; and 4) concurrent audit. Within that primary care area, quality of care has improved substantially in several aspects due to the use of the CPR system [1].

Improving quality management systems of laboratories in developing countries: an innovative training approach to accelerate laboratory accreditation.

PubMed

Yao, Katy; McKinney, Barbara; Murphy, Anna; Rotz, Phil; Wafula, Winnie; Sendagire, Hakim; Okui, Scolastica; Nkengasong, John N

2010-09-01

The Strengthening Laboratory Management Toward Accreditation (SLMTA) program was developed to promote immediate, measurable improvement in laboratories of developing countries. The laboratory management framework, a tool that prescribes managerial job tasks, forms the basis of the hands-on, activity-based curriculum. SLMTA is implemented through multiple workshops with intervening site visits to support improvement projects. To evaluate the effectiveness of SLMTA, the laboratory accreditation checklist was developed and subsequently adopted by the World Health Organization Regional Office for Africa (WHO AFRO). The SLMTA program and the implementation model were validated through a pilot in Uganda. SLMTA yielded observable, measurable results in the laboratories and improved patient flow and turnaround time in a laboratory simulation. The laboratory staff members were empowered to improve their own laboratories by using existing resources, communicate with clinicians and hospital administrators, and advocate for system strengthening. The SLMTA program supports laboratories by improving management and building preparedness for accreditation.

Improving performance with clinical decision support.

PubMed

Brailer, D J; Goldfarb, S; Horgan, M; Katz, F; Paulus, R A; Zakrewski, K

1996-07-01

CADU/CIS (Clinical and Administrative Decision-support Utility and Clinical Information System) is a clinical decision-support workstation that allows large volumes of clinical information systems data to be analyzed in a timely and user-friendly fashion. CARE PROCESS MEASUREMENT: For any given disease, subgroups of patients are identified, and automated, customized "clinical pathways" are generated. For each subgroup, the best practice norms for use of test and therapies are identified. Practice style variations are then compared to outcomes to focus inquiry on decisions that significantly affect outcomes. INTESTINAL OBSTRUCTION: Graduate Health Systems, a multisite integrated provider in the Philadelphia area, has used CADU/CIS to improve quality problems, reduce treatment-intensity variations, and improve clinical participation in care process evaluation and decision making. A task force selected intestinal obstruction without hernia as its first study because of the related high-volume and high-morbidity complications. Use of a ten-step method for clinical performance improvement showed that the intravenous administration of unnecessary fluids to 104 patients with intestinal obstruction induced congestive heart failure (CHF) in 5 patients. Task force members and other practicing physicians are now developing guidelines and other interventions aimed at fluid use. Indeed, the task force used CADU/CIS to identify an additional 250 patients in one year whose conditions were complicated by CHF. A clinical decision support tool can be instrumental in detecting problems with important clinical and economic implications, identifying their important underlying causes, tracking the associated tests and therapies, and monitoring interventions.

Research and Development in Very Long Baseline Interferometry (VLBI)

NASA Technical Reports Server (NTRS)

Himwich, William E.

2004-01-01

Contents include the following: 1.Observation coordination. 2. Data acquisition system control software. 3. Station support. 4. Correlation, data processing, and analysis. 5. Data distribution and archiving. 6. Technique improvement and research. 7. Computer support.

Parenting skills and family support programs for drug-abusing mothers.

PubMed

Kumpfer, Karol L; Fowler, Melissa A

2007-04-01

Children born to drug-using mothers can suffer from fetal alcohol or drug syndrome (FAS/FDS) or fetal alcohol or drug effect (FAE/FDE). Such children have a greater likelihood of developing acute or chronic physical, cognitive and behavioral problems. In-utero exposure to tobacco, alcohol or drugs impact on the developing fetus and, after birth, the family environment and family system exert effects on the infants and children of substance-abusing parents. Evidence-based prevention and maternal drug treatment programs focus on enhancing parental childcaring abilities, supporting parent-child attachment and encouraging family support systems to improve children's health and cognitive outcomes. FAS/FDS prevention programs, as well as selective and indicated prenatal and postnatal interventions, can improve the support given both to mother and to child, and evidence-based, in-home parenting and family-skills-training approaches are particularly useful.

Improving the durability of methanol oxidation reaction electro-catalysts through the modification of carbon architectures

NASA Astrophysics Data System (ADS)

Wood, Kevin N.

Carbon materials represent one of the largest areas of studied research today, having integrated applications stretching from energy production and storage to medical use and far beyond. One of these many intriguing applications is fuel cells, which offers the promise of clean electricity through a direct electrochemical energy conversion process. Unfortunately, at the present time the cost per watt-hour produced by fuel cells is more expensive than conventional methods of energy production/storage (i.e. combustion engines, batteries, etc.). Under the umbrella of fuel cell systems, methanol is a promising fuel source because of its high energy density and convenience of direct liquid fuel operation. In this field, recent advancements are bringing direct methanol fuel cells (DMFCs) closer to commercial viability. However, just as in other fuel cell systems, further improvements are greatly needed, particularly in the area of catalyst durability. This need for improved durability has led to increased research activity focused on improving catalyst stability and utilization. This thesis explores one of the most promising areas of enhancing catalyst-support interactions; namely, modification of carbon support architectures. Through the use of heteroatom modifiers, such as nitrogen, fuel cell support systems can be enhanced in such a way as to improve metal nucleation and growth, catalyst durability and catalytic activity. To this end, this thesis employs advanced characterization techniques to study the changes in catalyst particle morphology before and after nitrogen modification of the support structure. These results clearly show the beneficial effects of nitrogen moieties on carbon structures and help elucidate the effects of nitrogen on the stability of supported catalytic nanoparticles systems. Similarly, the novel concept of post-modifying commercially available supported catalysts with nitrogen ion implantation gives further insight into the behavior of modified support structures. This result shows a method by which current industry leading benchmarks can be improved, in some cases by up to 100%. This thesis also explores the intriguing prospect of heteroatom modification beyond the effects of just nitrogen. Specifically, the consequences of halide functionalization are explored and shown to significantly improve durability, even to a greater extent than nitrogen modification. In total these results give great promise for the future of fuel cell technology and the field of carbon modification in general. While the techniques and results presented in this thesis are employed to study durability in direct methanol fuel cells, the benefits of heteroatom modified carbon structures can be applied to other polymer electrolyte fuel cells and beyond. Many other devices and applications, including batteries, supercapacitors, hydrogen storage, and even biosensing and drug delivery can benefit from the work discussed within these pages.

Decision Support For Digester Algae Integration For Improved Environmental And Economic Sustainability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guillen, Donna P.; Panike, Katherine R.; Havlovick, Caryn M.

The Idaho National Laboratory (INL) has teamed with University of Idaho and Boise State University to make the use of ADs more attractive by implementing a two-stage AD and coupling additional processes to the system. The addition of a polyhydroxyalkanoate (PHA) reactor, algae cultivation system, and a biomass treatment system such as fast-pyrolysis or hydrothermal liquefaction (HTL) would further sequester carbon and nutrients, as well as add valuable products that can be sold or used on-site to mitigate costs. The Decision-support for Digester-Algae IntegRation for Improved Environmental and Economic Sustainability (DAIRIEES) technoeconomic model will play a key role in evaluatingmore » the effectiveness and viability of this system to achieve economic and environmental sustainability by the dairy industry.« less

UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

PubMed

Maners, Rebecca J; Bakow, Eric; Parkinson, Michael D; Fischer, Gary S; Camp, Geoffrey R

Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

Quality control and assurance in hematopoietic stem cell transplantation data registries in Japan and other countries.

PubMed

Kuwatsuka, Yachiyo

2016-01-01

Observational studies from national and international registries with large volumes of patients are commonly performed to identify superior strategies for hematopoietic stem cell transplantation. Major international and national stem cell transplant registries collect outcome data using electronic data capture systems, and a systematic study support process has been developed. Statistical support for studies is available from some major international registries, and international and national registries also mutually collaborate to promote stem cell transplant outcome studies and transplant-related activities. Transplant registries additionally take measures to improve data quality to further improve the quality of outcome studies by utilizing data capture systems and manual data management. Data auditing can potentially even further improve data quality; however, human and budgetary resources can be limiting factors in system construction and audits of the Japanese transplant registry are not currently performed.

Designing a data-driven decision support tool for nurse scheduling in the emergency department: a case study of a southern New Jersey emergency department.

PubMed

Otegbeye, Mojisola; Scriber, Roslyn; Ducoin, Donna; Glasofer, Amy

2015-01-01

A health system serving Burlington and Camden Counties, New Jersey, sought to improve labor productivity for its emergency departments, with emphasis on optimizing nursing staff schedules. Using historical emergency department visit data and operating constraints, a decision support tool was designed to recommend the number of emergency nurses needed in each hour for each day of the week. The pilot emergency department nurse managers used the decision support tool's recommendations to redeploy nurse hours from weekends into a float pool to support periods of demand spikes on weekdays. Productivity improved significantly, with no unfavorable impact on patient throughput, and patient and staff satisfaction. Today's emergency department manager can leverage the increasing ease of access to the emergency department information system's data repository to successfully design a simple but effective tool to support the alignment of its nursing schedule with demand patterns. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

The role of peer support in diabetes care and self-management.

PubMed

Brownson, Carol A; Heisler, Michele

2009-03-01

In light of the growing prevalence and healthcare costs of diabetes mellitus, it is critically important for healthcare providers to improve the efficiency and effectiveness of their diabetes care. A key element of effective disease management for diabetes is support for patient self-management. Barriers to care exist for both patients and healthcare systems. As a result, many people with diabetes do not get the care and support needed to successfully manage their diabetes.Disease management approaches that incorporate peer support may be a promising way to help provide self-management support to patients with diabetes. Trained peers provide emotional support, instrumental (tangible or material) support, education, and skills training to those they serve, and outreach and care coordination for provider systems. They play a unique role that complements and supports clinical care.To describe how peers are currently supporting diabetes care, a number of databases were searched for studies describing the roles of peers using relevant key words. This paper reviews current literature that describes the roles and duties of peers in interventions to improve diabetes care, with a focus on their contributions to six essential elements of self-management support: (i) access to regular, high-quality clinical care; (ii) an individualized approach to assessment and treatment; (iii) patient-centered collaborative goal setting; (iv) education and skills training; (v) ongoing follow-up and support; and (vi) linkages to community resources.Peers worked under a variety of titles, which did not define their duties. The scope of their work ranged from assisting health professionals to playing a central role in care. Providing education and follow-up support were the two most common roles. In all but one study, these roles were carried out during face-to-face contact, most frequently in community sites.A growing body of literature supports the value of peer models for diabetes management. Additional research can answer remaining questions related to such issues as cost effectiveness, sustainability, integration of peers into health and social service delivery systems, and recruitment, training, and support of peers. Continuing to develop and evaluate innovative models for more effectively mobilizing and integrating peers into diabetes care has great potential for improving diabetes outcomes worldwide.

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

A cloud medication safety support system using QR code and Web services for elderly outpatients.

PubMed

Tseng, Ming-Hseng; Wu, Hui-Ching

2014-01-01

Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

Observations to support adaptation: Principles, scales and decision-making

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2012-12-01

As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks including overcoming unrealistically precise information demands. While monitoring systems design and operation should be guided by the standards and requirements of management, those who provide information to the system (e.g. hydromet services) should also derive benefits. Drawing on identified information needs to support climate risk management (in drought, water resources and other areas) we outline principles of effective monitoring and develop preliminary strategic guidance for information systems being developed through the GEO, GCOS and Global and national frameworks for climate services. The efficacy of such services are improved by a problem-solving orientation, participatory planning, extension management and improvements in the use and value of existing data to legitimize new investments.

HT/HP x-tree and downhole fiber optic connectors and their use on subsea intelligent wells

NASA Astrophysics Data System (ADS)

Wright, Perry; Barlow, Stewart

2004-12-01

Offshore Oil and Gas R&D has been committed to improved reservoir performance through production monitoring. Technology improvements in these areas offer the greatest potential returns through increased knowledge of the reservoir, and the improvements in real-time production control that the technology and knowledge base can provide. One area of technology that supports this development is the growing application of fiber optic sensors for reservoir and production monitoring. These sensors cannot function in isolation, and need support in the form of fiber optic connection systems for x-tree penetrations. ODI have been developing products for fiber optic tree penetrations and down-hole wet connections for the last 4 years, working with Intelligent Wells Group at BP America Production Company in Houston. This paper discusses the application and reliability of fiber optic connectors, and reviews the development of the ODI I-CONN connection system and its application for vertical and horizontal x-trees, work-over systems and running tools, and down-hole systems.

Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

PubMed

Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

PubMed Central

2011-01-01

Background The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes. PMID:21824386

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

PubMed Central

Hamel, Donald J.; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D.; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T.; Okonkwo, Prosper; Kanki, Phyllis J.

2015-01-01

Introduction From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Methods Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Results Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Conclusions Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings. PMID:26900573

Proceedings of the 1983 SPC/IREAPS Technical Symposium: Volume 1, Improving Shipbuilding Productivity. Held in Boston, MA on 23-25 August 1983

DTIC Science & Technology

1983-08-25

currently available Westinghouse CAE capabilities include plant layout, piping design, piping analysis , support/hanger design, and drawing preparation. The...considerations involved with the design and analysis of piping and support systems and space management in nuclear power plants are very similar to...piping analysis system can obtain input defini- tion data either from the plant modeling system or from piping drawings (for systems not designed using

Miami regional advanced traveler information system project : final evaluation report

DOT National Transportation Integrated Search

2002-04-01

In 1999 the U.S. Congress earmarked funds for selected projects that were assessed as supporting the improvements of transportation efficiency, promoting safety, increasing traffic flow, reducing emissions, improving traveler information, enhancing a...

Towards public health decision support: a systematic review of bidirectional communication approaches

PubMed Central

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-01-01

Objective To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. Materials and Methods A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Results Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Conclusions Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows. PMID:23467470

State Knowledge Utilization Spotlight: Maryland. Transforming State Systems to Improve Outcomes for Children with Disabilities

ERIC Educational Resources Information Center

Pentimonti, Jill; Pfannenstiel, Kathleen; Walker, Melodee

2017-01-01

The selection of evidence-based practices (EBPs) in mathematics is a critical step toward improving mathematics outcomes for students with disabilities. This state spotlight presents how the Maryland State Department of Education uses the TAP-IT (Team, Analyze, Plan, Implement, and Track) process coupled with systems coaching to support the…

The Internal Coherence Framework: Creating the Conditions for Continuous Improvement in Schools

ERIC Educational Resources Information Center

Forman, Michelle L.; Stosich, Elizabeth Leisy; Bocala, Candice

2017-01-01

"The Internal Coherence Framework" presents a system of research-based practices for assessing and developing the conditions that support adult and student learning in schools. Internal coherence is defined as the ability of educators in a school or system to connect and align resources to carry out an improvement strategy, engage in…

Leadership Practices of a Principal in a High School with a High Teacher Retention Rate

ERIC Educational Resources Information Center

Branch, Ronald A., II

2013-01-01

As political and societal expectations for our nation's public school system continue to increase, leaders of local school systems are ever mindful of the demands for continual improvement. The cornerstone for this improvement is the classroom teacher. Research has supported the idea that teacher experience is influential in the effectiveness of…

Improving Student Retention through Evidence Based Proactive Systems at the Open University (UK)

ERIC Educational Resources Information Center

Gibbs, Graham; Regan, Peter; Simpson, Ormond

2007-01-01

The Open University has been undertaking an extended initiative to improve student retention through enhanced support for at-risk students. This initiative has evolved through a series of stages from ad hoc small scale local interventions relying largely on tutors and student self-referral, to an institution-wide pro-active system implemented by…

NURSE-LED INTERVENTION TO IMPROVE SURROGATE DECISION MAKING FOR PATIENTS WITH ADVANCED CRITICAL ILLNESS

PubMed Central

White, Douglas B.; Cua, Sarah Martin; Walk, Roberta; Pollice, Laura; Weissfeld, Lisa; Hong, Seoyeon; Landefeld, C. Seth; Arnold, Robert M.

2013-01-01

Background Problems persist with surrogate decision making in intensive care units, leading to distress for surrogates and treatment that may not reflect patients’ values. Objectives To assess the feasibility, acceptability, and perceived effectiveness of a multifaceted, nurse-led intervention to improve surrogate decision making in intensive care units. Study Design A single-center, single-arm, interventional study in which 35 surrogates and 15 physicians received the Four Supports Intervention, which involved incorporating a family support specialist into the intensive care team. That specialist maintained a longitudinal relationship with surrogates and provided emotional support, communication support, decision support, and anticipatory grief support. A mixed-methods approach was used to evaluate the intervention. Results The intervention was implemented successfully in all 15 patients, with a high level of completion of each component of the intervention. The family support specialist devoted a mean of 48 (SD 36) minutes per day to each clinician-patient-family triad. All participants reported that they would recommend the intervention to others. At least 90% of physicians and surrogates reported that the intervention (1) improved the quality and timeliness of communication, (2) facilitated discussion of the patient’s values and treatment preferences, and (3) improved the patient-centeredness of care. Conclusions The Four Supports Intervention is feasible, acceptable, and was perceived by physicians and surrogates to improve the quality of decision making and the patient-centeredness of care. A randomized trial is warranted to determine whether the intervention improves patient, family, and health system outcomes. PMID:23117903

Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

PubMed

Nair, Bala G; Grunzweig, Katherine; Peterson, Gene N; Horibe, Mayumi; Neradilek, Moni B; Newman, Shu-Fang; Van Norman, Gail; Schwid, Howard A; Hao, Wei; Hirsch, Irl B; Patchen Dellinger, E

2016-06-01

Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Compliance to hourly glucose measurements and correct insulin dose adjustments was compared for the baseline period (12 months) without SAM and the intervention period (12 months) with SAM decision support. Additionally, glucose management parameters were compared for the baseline and intervention periods. A total of 1587 cases during baseline and 1997 cases during intervention met the criteria for glucose management (diabetic patients or non-diabetic patients with glucose level >140 mg/dL). Among the intervention cases anesthesia providers chose to use SAM reminders 48.7 % of the time primarily for patients who had diabetes, higher HbA1C or body mass index, while disabling the system for the remaining cases. Compliance to hourly glucose measurement and correct insulin doses increased significantly during the intervention period when compared with the baseline (from 52.6 to 71.2 % and from 13.5 to 24.4 %, respectively). In spite of improved compliance to institutional protocol, the mean glucose levels and other glycemic management parameters did not show significant improvement with SAM reminders. Real-time electronic reminders improved intraoperative compliance to institutional glucose management protocol though glycemic parameters did not improve even when there was greater compliance to the protocol.

Dissemination of performance information and continuous improvement: A narrative systematic review.

PubMed

Lemire, Marc; Demers-Payette, Olivier; Jefferson-Falardeau, Justin

2013-01-01

Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

Portfolio Management

NASA Technical Reports Server (NTRS)

Duncan, Sharon L.

2011-01-01

Enterprise Business Information Services Division (EBIS) supports the Laboratory and its functions through the implementation and support of business information systems on behalf of its business community. EBIS Five Strategic Focus Areas: (1) Improve project estimating, planning and delivery capability (2) Improve maintainability and sustainability of EBIS Application Portfolio (3) Leap forward in IT Leadership (4) Comprehensive Talent Management (5) Continuous IT Security Program. Portfolio Management is a strategy in which software applications are managed as assets

Invited review: Experimental design, data reporting, and sharing in support of animal systems modeling research.

PubMed

McNamara, J P; Hanigan, M D; White, R R

2016-12-01

The National Animal Nutrition Program "National Research Support Project 9" supports efforts in livestock nutrition, including the National Research Council's committees on the nutrient requirements of animals. Our objective was to review the status of experimentation and data reporting in animal nutrition literature and to provide suggestions for the advancement of animal nutrition research and the ongoing improvement of field-applied nutrient requirement models. Improved data reporting consistency and completeness represent a substantial opportunity to improve nutrition-related mathematical models. We reviewed a body of nutrition research; recorded common phrases used to describe diets, animals, housing, and environmental conditions; and proposed equivalent numerical data that could be reported. With the increasing availability of online supplementary material sections in journals, we developed a comprehensive checklist of data that should be included in publications. To continue to improve our research effectiveness, studies utilizing multiple research methodologies to address complex systems and measure multiple variables will be necessary. From the current body of animal nutrition literature, we identified a series of opportunities to integrate research focuses (nutrition, reproduction and genetics) to advance the development of nutrient requirement models. From our survey of current experimentation and data reporting in animal nutrition, we identified 4 key opportunities to advance animal nutrition knowledge: (1) coordinated experiments should be designed to employ multiple research methodologies; (2) systems-oriented research approaches should be encouraged and supported; (3) publication guidelines should be updated to encourage and support sharing of more complete data sets; and (4) new experiments should be more rapidly integrated into our knowledge bases, research programs and practical applications. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Software Reuse Methods to Improve Technological Infrastructure for e-Science

NASA Technical Reports Server (NTRS)

Marshall, James J.; Downs, Robert R.; Mattmann, Chris A.

2011-01-01

Social computing has the potential to contribute to scientific research. Ongoing developments in information and communications technology improve capabilities for enabling scientific research, including research fostered by social computing capabilities. The recent emergence of e-Science practices has demonstrated the benefits from improvements in the technological infrastructure, or cyber-infrastructure, that has been developed to support science. Cloud computing is one example of this e-Science trend. Our own work in the area of software reuse offers methods that can be used to improve new technological development, including cloud computing capabilities, to support scientific research practices. In this paper, we focus on software reuse and its potential to contribute to the development and evaluation of information systems and related services designed to support new capabilities for conducting scientific research.

Passive magnetic bearing element with minimal power losses

DOEpatents

Post, R.F.

1998-12-08

Systems employing passive magnetic bearing elements having minimal power losses are provided. Improved stabilizing elements are shown, employing periodic magnet arrays and inductively loaded circuits, but with improved characteristics compared to the elements disclosed in US Patent No. 5,495,221 entitled ``Dynamically Stable Magnetic Suspension/Bearing System.`` The improvements relate to increasing the magnitude of the force derivative, while at the same time reducing the power dissipated during the normal operation of the bearing system, to provide a passive bearing system that has virtually no losses under equilibrium conditions, that is, when the supported system is not subject to any accelerations except those of gravity. 8 figs.

Passive magnetic bearing element with minimal power losses

DOEpatents

Post, Richard F.

1998-01-01

Systems employing passive magnetic bearing elements having minimal power losses are provided. Improved stabilizing elements are shown, employing periodic magnet arrays and inductively loaded circuits, but with improved characteristics compared to the elements disclosed in U.S. Patent No. 5,495,221 entitled "Dynamically Stable Magnetic Suspension/Bearing System." The improvements relate to increasing the magnitude of the force derivative, while at the same time reducing the power dissipated during the normal operation of the bearing system, to provide a passive bearing system that has virtually no losses under equilibrium conditions, that is, when the supported system is not subject to any accelerations except those of gravity.

Use of information systems in Air Force medical treatment facilities in strategic planning and decision-making.

PubMed

Yap, Glenn A; Platonova, Elena A; Musa, Philip F

2006-02-01

An exploratory study used Ansoff's strategic planning model as a framework to assess perceived effectiveness of information systems in supporting strategic business plan development at Air Force medical treatment facilities (MTFs). Results showed information systems were most effective in supporting historical trend analysis, strategic business plans appeared to be a balance of operational and strategic plans, and facilities perceived a greater need for new clinical, vice administrative, information systems to support strategic planning processes. Administrators believed information systems should not be developed at the local level and perceived information systems have the greatest impact on improving clinical quality outcomes, followed by ability to deliver cost effective care and finally, ability to increase market share.

Navy CALS Vision. Draft 2.0. Volume 25

DOT National Transportation Integrated Search

1990-10-01

Computer-aided Acquisition and Logistic Support (CALS) is a joint initiative between industry and the Department of Defense (DoD) that is targeted at: (1) Improving designs for weapon systems; (2) Reducing both acquisition and logistic support costs ...

Peer Mentoring--Is a Virtual Form of Support a Viable Alternative?

ERIC Educational Resources Information Center

Smailes, Joanne; Gannon-Leary, Pat

2011-01-01

Support systems are vital for university entrants and one established means of support is peer mentoring, which has the potential to improve student engagement and retention. Peer mentoring models are generally based on face-to-face contact. However, given the increasing number of higher education institutions using social media, might online…

Supporting Vocationally Oriented Learning in the High School Years: Rationale, Tasks, Challenges

ERIC Educational Resources Information Center

Halpern, Robert

2012-01-01

This article highlights the limitations of our current educational system in terms of vocational learning and highlights the role that vocational learning can play in supporting youth development and improving youth outcomes. It discusses the role that nonschool settings can play in supporting vocational learning and suggests strategies to improve…

Reengineering health care: management systems for survivors.

PubMed

Griffith, J R

1994-01-01

To survive in the coming era, health care organizations must support the powerful concepts of continuous quality improvement with better internal management systems that include: (1) new processes for making decisions from mission to clinical guidelines; (2) hoshin planning, which emphasizes strong financial management and innovation to meet customer needs; (3) new organizations that make cross-disciplinary teams as important as traditional clinical support services; and (4) expanded information covering several new dimensions, including enhanced analytic capability, and supporting both traditional organization and cross-disciplinary teams.

DECISION-SUPPORT TOOLS FOR MANAGING WASTEWATER COLLECTION SYSTEMS

EPA Science Inventory

Wastewater collection systems are an extensive part of the nation's infrastructure. As these systems become older, more preventative maintenance and renewal are required. For municipalities to cost-effectively plan, organize, and implement this effort, they require improved inf...

Integrating views on support for mid-level health worker performance: a concept mapping study with regional health system actors in rural Guatemala.

PubMed

Hernández, Alison R; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel

2015-10-08

Mid-level health workers are on the front-lines in underserved areas in many LMICs, and their performance is critical for improving the health of vulnerable populations. However, improving performance in low-resource settings is complex and highly dependent on the organizational context of local health systems. This study aims to examine the views of actors from different levels of a regional health system in Guatemala on actions to support the performance of auxiliary nurses, a cadre of mid-level health workers with a prominent role in public sector service delivery. A concept mapping study was carried out to develop an integrated view on organizational support and identify locally relevant strategies for strengthening performance. A total of 93 regional and district managers, and primary and secondary care health workers participated in generating ideas on actions needed to support auxiliary nurses' performance. Ideas were consolidated into 30 action items, which were structured through sorting and rating exercises, involving a total of 135 of managers and health workers. Maps depicting participants' integrated views on domains of action and dynamics in sub-groups' interests were generated using a sequence of multivariate statistical analyses, and interpreted by regional managers. The combined input of health system actors provided a multi-faceted view of actions needed to support performance, which were organized in six domains, including: Communication and coordination, Tools to orient work, Organizational climate of support, Motivation through recognition, Professional development and Skills development. The nature of relationships across hierarchical levels was identified as a cross-cutting theme. Pattern matching and go-zone maps indicated directions for action based on areas of consensus and difference across sub-groups of actors. This study indicates that auxiliary nurses' performance is interconnected with the performance of other health system actors who require support, including managers and community-level collaborators. Organizational climate is critical for making auxiliary nurses feel supported, and greater attention to improving the quality of hierarchical relationships is needed in LMIC settings. The participatory nature of the concept-mapping process enabled health system actors to collaborate in co-production of context-specific knowledge needed to guide efforts to strengthen performance in a vulnerable region.

A-Book: A Feedback-Based Adaptive System to Enhance Meta-Cognitive Skills during Reading.

PubMed

Guerra, Ernesto; Mellado, Guido

2017-01-01

In the digital era, tech devices (hardware and software) are increasingly within hand's reach. Yet, implementing information and communication technologies for educational contexts that have robust and long-lasting effects on student learning outcomes is still a challenge. We propose that any such system must a) be theoretically motivated and designed to tackle specific cognitive skills (e.g., inference making) supporting a given cognitive task (e.g., reading comprehension) and b) must be able to identify and adapt to the user's profile. In the present study, we implemented a feedback-based adaptive system called A-book (assisted-reading book) and tested it in a sample of 4th, 5th, and 6th graders. To assess our hypotheses, we contrasted three experimental assisted-reading conditions; one that supported meta-cognitive skills and adapted to the user profile (adaptive condition), one that supported meta-cognitive skills but did not adapt to the user profile (training condition) and a control condition. The results provide initial support for our proposal; participants in the adaptive condition improved their accuracy scores on inference making questions over time, outperforming both the training and control groups. There was no evidence, however, of significant improvements on other tested meta-cognitive skills (i.e., text structure knowledge, comprehension monitoring). We discussed the practical implications of using the A-book for the enhancement of meta-cognitive skills in school contexts, as well as its current limitations and future developments that could improve the system.

Breastfeeding protection, promotion, and support in the United States: a time to nudge, a time to measure.

PubMed

Pérez-Escamilla, Rafael; Chapman, Donna J

2012-05-01

Strong evidence-based advocacy efforts have now translated into high level political support and concrete goals for improving breastfeeding outcomes among women in the United States. In spite of this, major challenge remain for promoting, supporting and especially for protecting breastfeeding in the country. The goals of this commentary are to argue in favor of: A) Changes in the default social and environmental systems, that would allow women to implement their right to breastfeed their infants, B) A multi-level and comprehensive monitoring system to measure process and outcomes indicators in the country. Evidence-based commentary. Breastfeeding rates in the United States can improve based on a well coordinated social marketing framework. This approach calls for innovative promotion through mass media, appropriate facility based and community based support (e.g., Baby Friendly Hospital Initiative, WIC-coordinated community based peer counseling), and adequate protection for working women (e.g., longer paid maternity leave, breastfeeding or breast milk extraction breaks during the working day) and women at large by adhering and enforcing the WHO ethics Code for the Marketing of Breast Milk Substitutes. Sound infant feeding practices monitoring systems, which include WIC administrative food package data, are needed. Given the current high level of political support to improve breastfeeding in the United States, a window of opportunity has been opened. Establishing breastfeeding as the social norm in the USA will take time, but the global experience indicates that it can be done.

MOLAR: Modular Linux and Adaptive Runtime Support for HEC OS/R Research

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frank Mueller

2009-02-05

MOLAR is a multi-institution research effort that concentrates on adaptive, reliable,and efficient operating and runtime system solutions for ultra-scale high-end scientific computing on the next generation of supercomputers. This research addresses the challenges outlined by the FAST-OS - forum to address scalable technology for runtime and operating systems --- and HECRTF --- high-end computing revitalization task force --- activities by providing a modular Linux and adaptable runtime support for high-end computing operating and runtime systems. The MOLAR research has the following goals to address these issues. (1) Create a modular and configurable Linux system that allows customized changes based onmore » the requirements of the applications, runtime systems, and cluster management software. (2) Build runtime systems that leverage the OS modularity and configurability to improve efficiency, reliability, scalability, ease-of-use, and provide support to legacy and promising programming models. (3) Advance computer reliability, availability and serviceability (RAS) management systems to work cooperatively with the OS/R to identify and preemptively resolve system issues. (4) Explore the use of advanced monitoring and adaptation to improve application performance and predictability of system interruptions. The overall goal of the research conducted at NCSU is to develop scalable algorithms for high-availability without single points of failure and without single points of control.« less

FY2014 Electric Drive Technologies Annual Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

The Electric Drive Technologies research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research is focused on developing power electronics (PE), electric motor, and traction drive system (TDS) technologies that will reduce system cost and improve their efficiency in transforming battery energy to useful work. The R&D is also aimed at better understanding and improving how various components of tomorrow’s automobiles will function as a unified system to improve fuel efficiency.

FY2016 Electric Drive Technologies Annual Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

The Electric Drive Technologies research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research is focused on developing power electronics (PE), electric motor, and traction drive system (TDS) technologies that will reduce system cost and improve their efficiency in transforming battery energy to useful work. The R&D is also aimed at better understanding and improving how various components of tomorrow’s automobiles will function as a unified system to improve fuel efficiency.

FY2015 Electric Drive Technologies Annual Progress Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

The Electric Drive Technologies research and development (R&D) subprogram within the DOE Vehicle Technologies Office (VTO) provides support and guidance for many cutting-edge automotive technologies under development. Research is focused on developing power electronics (PE), electric motor, and traction drive system (TDS) technologies that will reduce system cost and improve their efficiency in transforming battery energy to useful work. The R&D is also aimed at better understanding and improving how various components of tomorrow’s automobiles will function as a unified system to improve fuel efficiency.

The standardized functional support sectional for the Small Astronomy Satellite (SAS)

NASA Technical Reports Server (NTRS)

Townsend, M. R.

1974-01-01

The standardized functional support section for the improved Small Astronomy Satellite (SAS) spacecraft, which can be used virtually without change for a wide variety of experimental packages and missions, is described. This functional support section makes the spacecraft remarkably flexible for a small satellite. Able to point its thrust axis to any direction in space, it can also spin or slow its outer body rotation to zero for star- or earth-locked pointing of side-viewing experiments. It features a reprogrammable telemetry system, a delayed command system, and an improved control system. Experiments can be built independently and attached to the SAS spacecraft just prior to final acceptance testing and launch. The spacecraft subsystems are described in detail. Included are a summary of the spacecraft characteristics, special design considerations, project reliability requirements, and environmental test conditions. It is intended that this new functional support section afford virtual off-the-shelf availability of the SAS spacecraft to independently built experiments, thus providing quick response time and minimum cost in meeting a wide variety of experimenter needs.

Adopting new technologies in stroke rehabilitation: the influence of the US health care system.

PubMed

Stein, J

2009-06-01

Stroke rehabilitation is entering a new era of technological innovation, including the development of robotic aids for therapy, peripheral electrical stimulation devices, and brain stimulation systems. These technologies have the potential to significantly improve the efficiency and efficacy of stroke rehabilitation. The United States health care system creates both opportunities for new technologies to be created and adopted, as well as important barriers. Inadequate support of clinical trials of the efficacy of new non-invasive devices is a particular concern for practitioners seeking to determine if new devices are clinically useful. Government support of clinical trials of efficacy, coupled with reform of FDA approval processes for novel therapies, is needed to create an evidence-based approach to improving stroke rehabilitation.

Low cost solar array project 1: Silicon material

NASA Technical Reports Server (NTRS)

Jewett, D. N.; Bates, H. E.; Hill, D. M.

1980-01-01

The low cost production of silicon by deposition of silicon from a hydrogen/chlorosilane mixture is described. Reactor design, reaction vessel support systems (physical support, power control and heaters, and temperature monitoring systems) and operation of the system are reviewed. Testing of four silicon deposition reactors is described, and test data and consequently derived data are given. An 18% conversion of trichlorosilane to silicon was achieved, but average conversion rates were lower than predicted due to incomplete removal of byproduct gases for recycling and silicon oxide/silicon polymer plugging of the gas outlet. Increasing the number of baffles inside the reaction vessel improved the conversion rate. Plans for further design and process improvements to correct the problems encountered are outlined.

Global Operational Remotely Sensed Evapotranspiration System for Water Resources Management: Case Study for the State of New Mexico

NASA Astrophysics Data System (ADS)

Halverson, G. H.; Fisher, J.; Magnuson, M.; John, L.

2017-12-01

An operational system to produce and disseminate remotely sensed evapotranspiration using the PT-JPL model and support its analysis and use in water resources decision making is being integrated into the New Mexico state government. A partnership between the NASA Western Water Applications Office (WWAO), the Jet Propulsion Laboratory (JPL), and the New Mexico Office of the State Engineer (NMOSE) has enabled collaboration with a variety of state agencies to inform decision making processes for agriculture, rangeland, and forest management. This system improves drought understanding and mobilization, litigation support, and economic, municipal, and ground-water planning through interactive mapping of daily rates of evapotranspiration at 1 km spatial resolution with near real-time latency. This is facilitated by daily remote sensing acquisitions of land-surface temperature and near-surface air temperature and humidity from the Moderate-Resolution Imaging Spectroradiometer (MODIS) instrument on the Terra satellite as well as the short-term composites of Normalized Difference Vegetation Index (NDVI) and albedo provided by MODIS. Incorporating evapotranspiration data into agricultural water management better characterizes imbalances between water requirements and supplies. Monitoring evapotranspiration over rangeland areas improves remediation and prevention of aridification. Monitoring forest evapotranspiration improves wildlife management and response to wildfire risk. Continued implementation of this decision support system should enhance water and food security.

Position Paper: Designing Complex Systems to Support Interdisciplinary Cognitive Work

NASA Technical Reports Server (NTRS)

Greene, Melissa T.; Papalambros, Panos Y.; Mcgowan, Anna-Maria R.

2016-01-01

The paper argues that the field we can call cognitive science of interdisciplinary collaboration is an important area of study for improving design of Large-Scale Complex Systems (LaCES) and supporting cognitive work. The paper mostly raised questions that have been documented in earlier qualitative analysis studies, and provided possible avenues of exploration for addressing them. There are likely further contributions from additional disciplines beyond those mentioned in this paper that should be considered and integrated into such a cognitive science framework. Knowledge and awareness of various perspectives will help to inform the types of interventions available for improving LaCES design and functionality. For example, a cognitive interpretation of interdisciplinary collaborations in LaCES elucidated the need for a "translator" or "mediator" in helping subject matter experts to transcend language boundaries, mitigate single discipline bias, support integrative activities, and correct misaligned objectives. Additional research in this direction is likely to uncover similar gaps and opportunities for improvements in practice.

Group Support Systems (GSS)

NASA Technical Reports Server (NTRS)

Hamel, Gary P.; Wijesinghe, R.

1996-01-01

Groupware is a term describing an emerging computer software technology enhancing the ability of people to work together as a group, (a software driven 'group support system'). This project originated at the beginning of 1992 and reports were issued describing the activity through May 1995. These reports stressed the need for process as well as technology. That is, while the technology represented a computer assisted method for groups to work together, the Group Support System (GSS) technology als required an understanding of the facilitation process electronic meetings demand. Even people trained in traditional facilitation techniques did not necessarily aimlessly adopt groupware techniques. The latest phase of this activity attempted to (1) improve the facilitation process by developing training support for a portable groupware computer system, and (2) to explore settings and uses for the portable groupware system using different software, such as Lotus Notes.

75 FR 59108 - Positive Train Control Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... established. No railroad had supplied data supporting further track exceptions from PTC system installation...-0132, Notice No. 4] RIN 2130-AC03 Positive Train Control Systems AGENCY: Federal Railroad... Control (PTC) systems for railroads as mandated by the Rail Safety Improvement Act of 2008. With...

Coordinated management of combined sewer overflows by means of environmental decision support systems.

PubMed

Murla, Damian; Gutierrez, Oriol; Martinez, Montse; Suñer, David; Malgrat, Pere; Poch, Manel

2016-04-15

During heavy rainfall, the capacity of sewer systems and wastewater treatment plants may be surcharged producing uncontrolled wastewater discharges and a depletion of the environmental quality. Therefore there is a need of advanced management tools to tackle with these complex problems. In this paper an environmental decision support system (EDSS), based on the integration of mathematical modeling and knowledge-based systems, has been developed for the coordinated management of urban wastewater systems (UWS) to control and minimize uncontrolled wastewater spills. Effectiveness of the EDSS has been tested in a specially designed virtual UWS, including two sewers systems, two WWTP and one river subjected to typical Mediterranean rain conditions. Results show that sewer systems, retention tanks and wastewater treatment plants improve their performance under wet weather conditions and that EDSS can be very effective tools to improve the management and prevent the system from possible uncontrolled wastewater discharges. Copyright © 2016 Elsevier B.V. All rights reserved.

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management.

PubMed

Midboe, Amanda M; Lewis, Eleanor T; Cronkite, Ruth C; Chambers, Dallas; Goldstein, Mary K; Kerns, Robert D; Trafton, Jodie A

2011-03-01

Development of clinical decision support systems (CDSs) has tended to focus on facilitating medication management. An understanding of behavioral medicine perspectives on the usefulness of a CDS for patient care can expand CDSs to improve management of chronic disease. The purpose of this study is to explore feedback from behavioral medicine providers regarding the potential for CDSs to improve decision-making, care coordination, and guideline adherence in pain management. Qualitative methods were used to analyze semi-structured interview responses from behavioral medicine stakeholders following demonstration of an existing CDS for opioid prescribing, ATHENA-OT. Participants suggested that a CDS could assist with decision-making by educating providers, providing recommendations about behavioral therapy, facilitating risk assessment, and improving referral decisions. They suggested that a CDS could improve care coordination by facilitating division of workload, improving patient education, and increasing consideration and knowledge of options in other disciplines. Clinical decision support systems are promising tools for improving behavioral medicine care for chronic pain.

Redesigning America's Schools: A Systems Approach to Improvement.

ERIC Educational Resources Information Center

Duffy, Francis M.; Rogerson, Lynda G.; Blick, Charles

Current school improvement tools are largely piecemeal and often lack credible supportive evidence. Knowledge Work Supervision (KWS) is built on the premise that schools must develop the capacity for sustaining districtwide improvements. Chapter 1, "The Past Before Us Is Not the Future," summarizes the key elements of the four phases of…

CDDIS: NASA's Archive of Space Geodesy Data and Products Supporting GGOS

NASA Technical Reports Server (NTRS)

Noll, Carey; Michael, Patrick

2016-01-01

The Crustal Dynamics Data Information System (CDDIS) supports data archiving and distribution activities for the space geodesy and geodynamics community. The main objectives of the system are to store space geodesy and geodynamics related data and products in a central archive, to maintain information about the archival of these data,to disseminate these data and information in a timely manner to a global scientific research community, and provide user based tools for the exploration and use of the archive. The CDDIS data system and its archive is a key component in several of the geometric services within the International Association of Geodesy (IAG) and its observing systemthe Global Geodetic Observing System (GGOS), including the IGS, the International DORIS Service (IDS), the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS), and the International Earth Rotation and Reference Systems Service (IERS). The CDDIS provides on-line access to over 17 Tbytes of dataand derived products in support of the IAG services and GGOS. The systems archive continues to grow and improve as new activities are supported and enhancements are implemented. Recently, the CDDIS has established a real-time streaming capability for GNSS data and products. Furthermore, enhancements to metadata describing the contents ofthe archive have been developed to facilitate data discovery. This poster will provide a review of the improvements in the system infrastructure that CDDIS has made over the past year for the geodetic community and describe future plans for the system.

Sorbent Structural Impacts Due to Humidity on Carbon Dioxide Removal Sorbents for Advanced Exploration Systems

NASA Technical Reports Server (NTRS)

Watson, David; Knox, James C.; West, Phillip; Stanley, Christine M.; Bush, Richard

2015-01-01

The Life Support Systems Project (LSSP) under the Advanced Exploration Systems (AES) program builds upon the work performed under the AES Atmosphere Resource Recovery and Environmental Monitoring (ARREM) project focusing on the numerous technology development areas. The CO2 removal and associated air drying development efforts are focused on improving the current state-of-the-art system on the International Space Station (ISS) utilizing fixed beds of sorbent pellets by seeking more robust pelletized sorbents, evaluating structured sorbents, and examining alternate bed configurations to improve system efficiency and reliability. A component of the CO2 removal effort encompasses structural stability testing of existing and emerging sorbents. Testing will be performed on dry sorbents and sorbents that have been conditioned to three humidity levels. This paper describes the sorbent structural stability screening efforts in support of the LSS Project within the AES Program.

Camera Ready Masters. B/M-1 Resource Assessment. B/M-2 Surveying. B/M-3 Tabulation. B/M-4 Selecting Program Goals. B/M-5 Producing CDU's. Career Planning Support System.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center for Vocational Education.

This package of camera ready masters is one of a set of twelve documents describing the Career Planning Support System (CPSS) and its use. (CPSS is a comprehensive guidance program management system which (1) provides techniques to improve a high school's career guidance program, (2) focuses on the skills students need to make decisions about and…

Generalized environmental control and life support system computer program (G189A) configuration control. [computer subroutine libraries for shuttle orbiter analyses

NASA Technical Reports Server (NTRS)

Blakely, R. L.

1973-01-01

A G189A simulation of the shuttle orbiter EC/lSS was prepared and used to study payload support capabilities. Two master program libraries of the G189A computer program were prepared for the NASA/JSC computer system. Several new component subroutines were added to the G189A program library and many existing subroutines were revised to improve their capabilities. A number of special analyses were performed in support of a NASA/JSC shuttle orbiter EC/LSS payload support capability study.

Benefits and challenges of health information systems for operations research: an illustrative example to improve surgical scheduling.

PubMed

Chow, Vincent S; Huang, Wenhai; Puterman, Martin L

2009-01-01

Operations research (OR) is playing an increasing role in the support of many health care initiatives. However one of the main challenges facing OR practitioners is the availability and the integrity of operations data. Hospital information systems (HIS) are often designed with a clinical or accounting focus and may lack the data necessary for operational studies. In this paper, we illustrate the data processing methods and data challenges faced by our team during a study of surgical scheduling practices at the Vancouver Island Health Authority. We also provide some general recommendations to improve HIS from an operations perspective. In general, more integration between operations researchers and HIS specialists are required to support ongoing operational improvements in the health care sector.

Programs That Support Safety and Security for the Transit Industry

DOT National Transportation Integrated Search

2001-03-01

FTA's Office of Safety and Security (Office) directly supports the U.S. Department of Transportation's safety goals through a series of programs designed to maintain continuous improvement in the safety and security of our nation's transit systems. T...

Research on Current Water Systems and Regulatory Support

EPA Science Inventory

This project will supply research results to support federal regulations and guidance. It will also provide strategies to regions, states, and communities for improved regulatory compliance and rapid and effective emergency response where appropriate (e.g. harmful algal bloom out...

Improving patient access and streamlining processes through enterprise intelligence systems.

PubMed

Dunn, Ronald L

2014-01-01

This article demonstrates how enterprise intelligence systems can be used to improve operational efficiency in hospitals. Enterprise intelligence systems mine raw data from disparate systems and transform the data into actionable information, which when used appropriately, support streamlined processes, optimize resources, and positively affect staff efficiency and the quality of patient care. Case studies on the implementation of McKesson Performance Visibility and Capacity Planner enterprise intelligence solutions at the Southlake Regional Health Centre and Lions Gate and Richmond Hospitals are provided.

Air Force Journal of Logistics: Logistics Dimensions Improving Bare Base Agile Combat Support, The Path to Integration. Volume 28, Number 2

DTIC Science & Technology

2004-01-01

the system is balanced, there is the right flow of new pilots to match the availability of instructors for initial training missions, the right mix of...which attempted to redesign and streamline the DoD global distribution system , significantly improved delivery time to test locations.4 During its...somewhat confusing priority system that does not guarantee cargo delivery at a specific time and a pricing system that does not adequately differentiate

Visually Coupled Systems (VCS): The Virtual Panoramic Display (VPD) System

NASA Technical Reports Server (NTRS)

Kocian, Dean F.

1992-01-01

The development and impact is described of new visually coupled system (VCS) equipment designed to support engineering and human factors research in the military aircraft cockpit environment. VCS represents an advanced man-machine interface (MMI). Its potential to improve aircrew situational awareness seems enormous, but its superiority over the conventional cockpit MMI has not been established in a conclusive and rigorous fashion. What has been missing is a 'systems' approach to technology advancement that is comprehensive enough to produce conclusive results concerning the operational viability of the VCS concept and verify any risk factors that might be involved with its general use in the cockpit. The advanced VCS configuration described here, was ruggedized for use in military aircraft environments and was dubbed the Virtual Panoramic Display (VPD). It was designed to answer the VCS portion of the systems problem, and is implemented as a modular system whose performance can be tailored to specific application requirements. The overall system concept and the design of the two most important electronic subsystems that support the helmet mounted parts, a new militarized version of the magnetic helmet mounted sight and correspondingly similar helmet display electronics, are discussed in detail. Significant emphasis is given to illustrating how particular design features in the hardware improve overall system performance and support research activities.

Analysis of the risk management decisionmaking processes and the decision support systems in the wildland fire agencies

Treesearch

Patrick Withen

2007-01-01

This paper offers an analysis of the strengths, weaknesses, opportunities, and threats in the risk management process, decision support systems (DSSs), and other types of decisionmaking, including recognition primed decisionmaking, bricolage with the goal of improving DSSs and decisionmaking. DSSs may be thought of as any technology or knowledge that is used as an aid...

Development of a Decision Support System for Monitoring, Reporting, Forecasting Ecological Conditions of the Appalachian Trail

Treesearch

Y. Wang; R. Nemani; F. Dieffenbach; K. Stolte; G. Holcomb

2010-01-01

This paper introduces a collaborative multi-agency effort to develop an Appalachian Trail (A.T.) MEGA-Transect Decision Support System (DSS) for monitoring, reporting and forecasting ecological conditions of the A.T. and the surrounding lands. The project is to improve decision-making on management of the A.T. by providing a coherent framework for data integration,...

Positive Behavior Support in Schools (PBSIS): An Administrative Perspective on the Implementation of a Comprehensive School-Wide Intervention in an Urban Charter School

ERIC Educational Resources Information Center

Christofferson, Remi Dabney; Callahan, Kathe

2015-01-01

This research explores the implementation of a school-wide intervention program that was designed to foster and instill intrinsic values based on an external reward system. The Positive Behavior Support in Schools (PBSIS) is an intervention intended to improve the climate of schools using system-wide positive behavioral interventions to discourage…

Opportunities and Design Considerations for Peer Support in a Hospital Setting.

PubMed

Haldar, Shefali; Mishra, Sonali R; Khelifi, Maher; Pollack, Ari H; Pratt, Wanda

2017-05-01

Although research has demonstrated improved outcomes for outpatients who receive peer support-such as through online health communities, support groups, and mentoring systems-hospitalized patients have few mechanisms to receive such valuable support. To explore the opportunities for a hospital-based peer support system, we administered a survey to 146 pediatric patients and caregivers, and conducted semi-structured interviews with twelve patients and three caregivers in a children's hospital. Our analysis revealed that hospitalized individuals need peer support for five key purposes: (1) to ask about medical details-such as procedures, treatments, and medications; (2) to learn about healthcare providers; (3) to report and prevent medical errors; (4) to exchange emotional support; and (5) to manage their time in the hospital. In this paper, we examine these themes and describe potential barriers to using a hospital-based peer support system. We then discuss the unique opportunities and challenges that the hospital environment presents when designing for peer support in this setting.

Improving Performance on Preventive Health Quality Measures Using Clinical Decision Support to Capture Care Done Elsewhere and Patient Exceptions.

PubMed

Bowen, Michael E; Bhat, Deepa; Fish, Jason; Moran, Brett; Howell-Stampley, Temple; Kirk, Lynne; Persell, Stephen D; Halm, Ethan A

Preventive services required for performance measurement often are completed in outside health systems and not captured in electronic medical records (EMRs). A before-after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement. CDS improved performance on colorectal cancer screening, osteoporosis screening, and pneumococcal vaccination measures ( P < .05) but not breast or cervical cancer screening. CDS captured clinician-reported services completed elsewhere (2% to 10%) and patient/medical exceptions (<3%). Compared to measures using only within-system data, including services completed elsewhere in the numerator improved performance: pneumococcal vaccine (73% vs 82%); breast (69% vs 75%), colorectal (58% vs 70%), and cervical cancer (53% vs 62%); and osteoporosis (72% vs 75%) screening ( P < .05). Visit-based CDS can capture clinician-reported preventive services, and accounting for services completed elsewhere improves performance on quality measures.

Potential benefits of magnetic suspension and balance systems

NASA Technical Reports Server (NTRS)

Lawing, Pierce L.; Dress, David A.; Kilgore, Robert A.

1987-01-01

The potential of Magnetic Suspension and Balance Systems (MSBS) to improve conventional wind tunnel testing techniques is discussed. Topics include: elimination of model geometry distortion and support interference to improve the measurement accuracy of aerodynamic coefficients; removal of testing restrictions due to supports; improved dynamic stability data; and stores separation testing. Substantial increases in wind tunnel productivity are anticipated due to the coalescence of these improvements. Specific improvements in testing methods for missiles, helicopters, fighter aircraft, twin fuselage transports and bombers, state separation, water tunnels, and automobiles are also forecast. In a more speculative vein, new wind tunnel test techniques are envisioned as a result of applying MSBS, including free-flight computer trajectories in the test section, pilot-in-the-loop and designer-in-the-loop testing, shipboard missile launch simulation, and optimization of hybrid hypersonic configurations. Also addressed are potential applications of MSBS to such diverse technologies as medical research and practice, industrial robotics, space weaponry, and ore processing in space.

New technologies for supporting real-time on-board software development

NASA Astrophysics Data System (ADS)

Kerridge, D.

1995-03-01

The next generation of on-board data management systems will be significantly more complex than current designs, and will be required to perform more complex and demanding tasks in software. Improved hardware technology, in the form of the MA31750 radiation hard processor, is one key component in addressing the needs of future embedded systems. However, to complement these hardware advances, improved support for the design and implementation of real-time data management software is now needed. This will help to control the cost and risk assoicated with developing data management software development as it becomes an increasingly significant element within embedded systems. One particular problem with developing embedded software is managing the non-functional requirements in a systematic way. This paper identifies how Logica has exploited recent developments in hard real-time theory to address this problem through the use of new hard real-time analysis and design methods which can be supported by specialized tools. The first stage in transferring this technology from the research domain to industrial application has already been completed. The MA37150 Hard Real-Time Embedded Software Support Environment (HESSE) is a loosely integrated set of hardware and software tools which directly support the process of hard real-time analysis for software targeting the MA31750 processor. With further development, this HESSE promises to provide embedded system developers with software tools which can reduce the risks associated with developing complex hard real-time software. Supported in this way by more sophisticated software methods and tools, it is foreseen that MA31750 based embedded systems can meet the processing needs for the next generation of on-board data management systems.

Test Review: F. M. Gresham & S. N. Elliott "Social Skills Improvement System Rating Scales." Minneapolis, Minnesota--NCS Pearson, 2008

ERIC Educational Resources Information Center

Crosby, James W.

2011-01-01

The "Social Skills Improvement System" (SSIS; Gresham & Elliot, 2008) is designed to assist in the screening and classification of students (ages 8 to 18) who are suspected of having significant social skills deficits, and to offer support in the development of interventions for those found to display significant social skills…

Improving the Defense Acquisition System and Reducing System Costs

DTIC Science & Technology

1981-03-30

The need for this specific commitment results from the competition among the conflicting objectives of high perform- ance, lower cost, shorter... conflict with initiatives to improve reliability and support. Whereas the fastest acquisition approach involves initiating production prxor to...their Individual thrusts result in confusion on the part of OASD who tries to implement conflicting programs, and of defense contractors performing

Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Powell, Danny H; Elwood Jr, Robert H

2011-01-01

An effective risk assessment system is needed to address the threat posed by an active or passive insider who, acting alone or in collusion, could attempt diversion or theft of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) is a self-assessment or inspection tool utilizing probabilistic risk assessment (PRA) methodology to calculate the system effectiveness of a nuclear facility's material protection, control, and accountability (MPC&A) system. The MSET process is divided into four distinct and separate parts: (1) Completion of the questionnaire that assembles information about the operations of every aspect of the MPC&A system; (2)more » Conversion of questionnaire data into numeric values associated with risk; (3) Analysis of the numeric data utilizing the MPC&A fault tree and the SAPHIRE computer software; and (4) Self-assessment using the MSET reports to perform the effectiveness evaluation of the facility's MPC&A system. The process should lead to confirmation that mitigating features of the system effectively minimize the threat, or it could lead to the conclusion that system improvements or upgrades are necessary to achieve acceptable protection against the threat. If the need for system improvements or upgrades is indicated when the system is analyzed, MSET provides the capability to evaluate potential or actual system improvements or upgrades. A facility's MC&A system can be evaluated at a point in time. The system can be reevaluated after upgrades are implemented or after other system changes occur. The total system or specific subareas within the system can be evaluated. Areas of potential system improvement can be assessed to determine where the most beneficial and cost-effective improvements should be made. Analyses of risk importance factors show that sustainability is essential for optimal performance and reveals where performance degradation has the greatest impact on total system risk. The risk importance factors show the amount of risk reduction achievable with potential upgrades and the amount of risk reduction achieved after upgrades are completed. Applying the risk assessment tool gives support to budget prioritization by showing where budget support levels must be sustained for MC&A functions most important to risk. Results of the risk assessment are also useful in supporting funding justifications for system improvements that significantly reduce system risk. The functional model, the system risk assessment tool, and the facility evaluation questionnaire are valuable educational tools for MPC&A personnel. These educational tools provide a framework for ongoing dialogue between organizations regarding the design, development, implementation, operation, assessment, and sustainability of MPC&A systems. An organization considering the use of MSET as an analytical tool for evaluating the effectiveness of its MPC&A system will benefit from conducting a complete MSET exercise at an existing nuclear facility.« less

Beyond bureaucracy: emerging trends in social care informatics.

PubMed

Wastell, David; White, Sue

2014-09-01

Existing information technology systems in much of UK social care have been designed to serve the interests of the bureaucracy rather than supporting professional practice or improving services to the public. The ill-starred Integrated Children's System in statutory children's services is typical. The Integrated Children's System is a system for form-filling, micro-managing professional practice through an enforced regime of standard processes and time scales. In this article, we argue against this dominant design. We provide several examples where technology has enabled alternative modes of support for professional work, based on socio-technical principles. One such system is Patchwork, which describes itself as a 'Facebook for Social Work'; its aim is to support multi-professional teams working with vulnerable families. © The Author(s) 2013.

Using Visualization in Cockpit Decision Support Systems

NASA Technical Reports Server (NTRS)

Aragon, Cecilia R.

2005-01-01

In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

Using Technology Readiness Level (TRL), Life Cycle Cost (LCC), and Other Metrics to Supplement Equivalent System Mass (ESM) in Advanced Life Support (ALS)

NASA Technical Reports Server (NTRS)

Jones, Harry

2003-01-01

The ALS project plan goals are reducing cost, improving performance, and achieving flight readiness. ALS selects projects to advance the mission readiness of low cost, high performance technologies. The role of metrics is to help select good projects and report progress. The Equivalent Mass (EM) of a system is the sum of the estimated mass of the hardware, of its required materials and spares, and of the pressurized volume, power supply, and cooling system needed to support the hardware in space. EM is the total payload launch mass needed to provide and support a system. EM is directly proportional to the launch cost.

Science and Systems in Support of Multi-hazard Early Warnings and Decisions

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2015-12-01

The demand for improved climate knowledge and information is well documented. As noted in the IPCC (SREX, AR5), the UNISDR Global Assessment Reports and other assessments, this demand has increased pressure for information to support planning under changing rates and emergence of multiple hazards including climate extremes (drought, heat waves, floods). "Decision support" is now a popular term in the climate applications research community. While existing decision support activities can be identified in many disparate settings (e.g. federal, academic, private), the challenge of changing environments (coupled physical and social) is actually one of crafting implementation strategies for improving decision quality (not just meeting "user needs"). This includes overcoming weaknesses in co-production models, moving beyond DSSs as simply "software", coordinating innovation mapping and diffusion, and providing fora and gaming tools to identify common interests and differences in the way risks are perceived and managed among the affected groups. We outline the development and evolution of multi-hazard early warning systems in the United States and elsewhere, focusing on climate-related hazards. In particular, the presentation will focus on the climate science and information needed for (1) improved monitoring and modeling, (2) generating risk profiles, (3) developing information systems and scenarios for critical thresholds, (4) the net benefits of using new information (5) characterizing and bridging the "last mile" in the context of longer-term risk management.

Thinking on Sichuan-Chongqing gas pipeline transportation system reform under market-oriented conditions

NASA Astrophysics Data System (ADS)

Duan, Yanzhi

2017-01-01

The gas pipeline networks in Sichuan and Chongqing (Sichuan-Chongqing) region have formed a fully-fledged gas pipeline transportation system in China, which supports and promotes the rapid development of gas market in Sichuan-Chongqing region. In the circumstances of further developed market-oriented economy, it is necessary to carry out further the pipeline system reform in the areas of investment/financing system, operation system and pricing system to lay a solid foundation for improving future gas production and marketing capability and adapting itself to the national gas system reform, and to achieve the objectives of multiparty participated pipeline construction, improved pipeline transportation efficiency and fair and rational pipeline transportation prices. In this article, main thinking on reform in the three areas and major deployment are addressed, and corresponding measures on developing shared pipeline economy, providing financial support to pipeline construction, setting up independent regulatory agency to enhance the industrial supervision for gas pipeline transportation, and promoting the construction of regional gas trade market are recommended.

NASA Advanced Explorations Systems: Advancements in Life Support Systems

NASA Technical Reports Server (NTRS)

Shull, Sarah A.; Schneider, Walter F.

2016-01-01

The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA's Habitability Architecture Team (HAT). The LSS project is focused on four areas: architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the international space station (ISS) LSS systems as a point of departure (where applicable), the mission of the LSS project is three-fold: 1. Address discrete LSS technology gaps 2. Improve the reliability of LSS systems 3. Advance LSS systems towards integrated testing on the ISS. This paper summarized the work being done in the four areas listed above to meet these objectives. Details will be given on the following focus areas: Systems Engineering and Architecture- With so many complex systems comprising life support in space, it is important to understand the overall system requirements to define life support system architectures for different space mission classes, ensure that all the components integrate well together and verify that testing is as representative of destination environments as possible. Environmental Monitoring- In an enclosed spacecraft that is constantly operating complex machinery for its own basic functionality as well as science experiments and technology demonstrations, it's possible for the environment to become compromised. While current environmental monitors aboard the ISS will alert crew members and mission control if there is an emergency, long-duration environmental monitoring cannot be done in-orbit as current methodologies rely largely on sending environmental samples back to Earth. The LSS project is developing onboard analysis capabilities that will replace the need to return air and water samples from space for ground analysis. Air Revitalization- The air revitalization task is comprised of work in carbon dioxide removal, oxygen generation and recovery and trace contamination and particulate control. The CO2 Removal and associated air drying development efforts under the LSS project are focused both on improving the current SOA technology on the ISS and assessing and examining the viability of other sorbents and technologies available in academia and industry. The Oxygen Generation and Recovery technology development area encompasses several sub-tasks in an effort to supply O2 to the crew at the required conditions, to recover O2 from metabolic CO2, and to recycle recovered O2 back to the cabin environment. Current state-of-the-art oxygen generation systems aboard space station are capable of generating or recovering approximately 40% of required oxygen; for exploration missions this percentage needs to be greatly increased. A spacecraft cabin trace contaminant and particulate control system serves to keep the environment below the spacecraft maximum allowable concentration (SMAC) for chemicals and particulates. Both passive (filters) and active (scrubbers) methods contribute to the overall TC & PC design. Work in the area of trace contamination and particulate control under the LSS project is focused on making improvements to the SOA TC & PC systems on ISS to improve performance and reduce consumables. Wastewater Processing and Water Management- A major goal of the LSS project is the development of water recovery systems to support long duration human exploration beyond LEO. Current space station wastewater processing and water management systems distill urine and wastewater to recover water from urine and humidity condensate in the spacecraft at a approximately 74% recovery rate. For longer, farther missions into deep space, that recovery rate must be greatly increased so that astronauts can journey for months without resupply cargo ships from Earth.

Improving access to electronic health records for people with intellectual disability: a qualitative study.

PubMed

van Dooren, Kate; Lennox, Nick; Stewart, Madeline

2013-01-01

People with intellectual disability represent ~2-3% of the Australian population and experience elevated rates of mortality and morbidity compared with the general population. People with intellectual disability, and their families and carers, must keep track of extensive medical information while also managing turnover of paid staff, general practitioners and other health professionals, making them beneficiaries of Australia's new eHealth record system. Although they are key users, there is a lack of knowledge about the accessibility of the system for individuals with intellectual disability, or those responsible for managing their health information. This is a missed opportunity to improve the lives of an already overlooked group. This study aimed to identify the facilitators and barriers to registering for an eHealth record network for people with intellectual disability and those supporting them to manage their health information. We interviewed potential users of eHealth records, including four people with intellectual disability, three family members and two residential support workers. Our findings suggest that decision-makers involved in the roll-out of the eHealth record networks should incorporate 'reasonable accommodations' to improve accessibility for people with intellectual disability and those who support them to manage their health information. This includes identifying and eliminating the barriers to accessibility of eHealth records and taking appropriate measures to promote access to individuals with intellectual disability. People with intellectual disability and the people who support them are a diverse group with a range of abilities. The translation of their views into practice will help to improve the eHealth system for this and other vulnerable population groups.

Android Protection Mechanism: A Signed Code Security Mechanism for Smartphone Applications

DTIC Science & Technology

2011-03-01

status registers, exceptions, endian support, unaligned access support, synchronization primitives , the Jazelle Extension, and saturated integer...supports comprehensive non-blocking shared-memory synchronization primitives that scale for multiple-processor system designs. This is an improvement... synchronization . Memory semaphores can be loaded and altered without interruption because the load and store operations are atomic. Processor

Developing and Implementing Effective Communications Systems: Improving SEA Communication with LEAs, Partners/Vendors, and the Public. Benchmark. No. 2

ERIC Educational Resources Information Center

Brasiel, S.; Nafziger, D.

2013-01-01

State education agencies (SEAs) are central players in initiating and leading new reform efforts and in supporting and implementing Federal initiatives. Traditional approaches to providing public information are not adequate for producing public awareness and support and in supporting program implementation at the local level. With limited…

Designing a Semantic Bliki System to Support Different Types of Knowledge and Adaptive Learning

ERIC Educational Resources Information Center

Huang, Shiu-Li; Yang, Chia-Wei

2009-01-01

Though blogs and wikis have been used to support knowledge management and e-learning, existing blogs and wikis cannot support different types of knowledge and adaptive learning. A case in point, types of knowledge vary greatly in category and viewpoints. Additionally, adaptive learning is crucial to improving one's learning performance. This study…

It's Not Just About More Data: Translation of Science and Decision Support Evaluation for Climate Impact Indicators

NASA Astrophysics Data System (ADS)

Kenney, M. A.

2014-12-01

The U.S. Global Change Research Program is currently considering establishing a National Climate Indicators System, which would be a set of physical, ecological, and societal indicators that would communicate key aspects of climate changes, impacts, vulnerabilities, and preparedness to inform mitigation and adaptation decisions. Thus, over the past several years 150+ scientists and practitioners representing a range of expertise from the climate system to natural systems to human sectors have developed a set of indicator recommendations that could be used as a first step to establishing such an indicator system. These recommendations have been implemented into a pilot system, with the goal of working with stakeholder communities to evaluate the understandability of individual indicators and learn how users are combining indicators for their own understanding or decision needs through this multiple Federal agency decision support platform. This prototype system provides the perfect test bed for evaluating the translation of scientific data - observations, remote sensing, and citizen science data -- and data products, such as indicators, for decision-making audiences. Often translation of scientific information into decision support products is developed and improved given intuition and feedback. Though this can be useful in many cases, more rigorous testing using social science methodologies would provide greater assurance that the data products are useful for the intended audiences. I will present some initial research using surveys to assess the understandability of indicators and whether that understanding is influenced by one's attitude toward climate change. Such information is critical to assess whether products developed for scientists by scientists have been appropriately translated for non-scientists, thus assuring that the data will have some value for the intended audience. Such survey information will provide a data driven approach to further develop and improve the National Climate Indicators System and could be applied to improve other decision support systems.

Improving Patient Safety in Hospitals through Usage of Cloud Supported Video Surveillance.

PubMed

Dašić, Predrag; Dašić, Jovan; Crvenković, Bojan

2017-04-15

Patient safety in hospitals is of equal importance as providing treatments and urgent healthcare. With the development of Cloud technologies and Big Data analytics, it is possible to employ VSaaS technology virtually anywhere, for any given security purpose. For the listed benefits, in this paper, we give an overview of the existing cloud surveillance technologies which can be implemented for improving patient safety. Modern VSaaS systems provide higher elasticity and project scalability in dealing with real-time information processing. Modern surveillance technologies can prove to be an effective tool for prevention of patient falls, undesired movement and tempering with attached life supporting devices. Given a large number of patients who require constant supervision, a cloud-based monitoring system can dramatically reduce the occurring costs. It provides continuous real-time monitoring, increased overall security and safety, improved staff productivity, prevention of dishonest claims and long-term digital archiving. Patient safety is a growing issue which can be improved with the usage of high-end centralised surveillance systems allowing the staff to focus more on treating health issues rather that keeping a watchful eye on potential incidents.

Enhancement of the EPA Stormwater BMP Decision-Support Tool (SUSTAIN)

EPA Science Inventory

U.S. Environmental Protection Agency (EPA) has been developing and improving a decision-support tool for placement of stormwater best management practices (BMPs) at strategic locations in urban watersheds. The tool is called the System for Urban Stormwater Treatment and Analysis...

Supportive intervention using a mobile phone in behavior modification.

PubMed

Hareva, David H; Okada, Hiroki; Kitawaki, Tomoki; Oka, Hisao

2009-04-01

The authors previously developed a mobile ecological momentary assessment (EMA) system as a real-time data collection device using a mobile phone. In this study, a real-time advice function and real-time reporting function were added to the previous system as a supportive intervention. The improved system was found to work effectively and was applied to several clinical cases, including patients with depressive disorder, dizziness, smoking habit, and bronchial asthma. The average patient compliance rate was high (89%) without the real-time advice and higher (93%) with the advice. The trends in clinical data for patients using a mobile EMA with/without the new function were analyzed for up to several months. In the case of dizziness, an improving trend in its clinical data was observed after applying the real-time advice, and in the case of depressive disorder, a stabilizing trend was observed. The mobile EMA system with the real-time advice function could be useful as a supportive intervention in behavior modification and for motivating patients in self-management of their disease.

Online support system for students in higher education: Proof-of-concept study

PubMed Central

Touloumakos, Anna K; Goozée, Rhianna; Papadatou-Pastou, Marietta; Barley, Elizabeth; Haddad, Mark; Tzotzoli, Patapia

2016-01-01

Background Providing support to the increasing numbers of students facing mental health difficulties in higher education (HE) can be difficult due to stigma or lack of resources. Alternative and/or complementary sources of support are needed, such as online interventions that are recognised for their therapeutic value and cost-effectiveness. Objectives We aim to provide evidence supporting the conceptual and practical value of a newly developed online multimedia intervention system for HE students who face mild to moderate symptoms of anxiety and depression and study-skills difficulties. Methods Students from five universities were invited to participate in a cross-sectional proof-of-concept study. Students were invited through the universities’ internal communication channels. Following demonstration of each part of the system, students completed a survey with quantitative and qualitative questions. Results Response was largely positive. Positive responses on the features of the questionnaire ranged between 65% and 86%; on the features of the workshops ranged between 57% and 91%; on ‘My place’ ranged between 65% and 79%; on the animated videos ranged between 79% and 92%; and on the overall system ranged between 78% and 89%. Participants indicated areas for improvement and ways in which such improvement could be accomplished; these then guided the development of the system. Conclusions The results confirm the need for such a system. It can complement student support services (SSS) by dealing with cases with mild to moderate difficulties, hence allowing SSS to prioritise and effectively address more severe cases. Potentially this method can provide a meaningful alternative to SSS; this is worth investigating further.

An Integrated Gate Turnaround Management Concept Leveraging Big Data/Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William; Chachad, Girish; Hochstetler, Ronald

2016-01-01

The Integrated Gate Turnaround Management (IGTM) concept was developed to improve the gate turnaround performance at the airport by leveraging relevant historical data to support optimization of airport gate operations, which include: taxi to the gate, gate services, push back, taxi to the runway, and takeoff, based on available resources, constraints, and uncertainties. By analyzing events of gate operations, primary performance dependent attributes of these events were identified for the historical data analysis such that performance models can be developed based on uncertainties to support descriptive, predictive, and prescriptive functions. A system architecture was developed to examine system requirements in support of such a concept. An IGTM prototype was developed to demonstrate the concept using a distributed network and collaborative decision tools for stakeholders to meet on time pushback performance under uncertainties.

Preventive intervention in diabetes: a new model for continuing medical education.

PubMed

Beaser, Richard S; Brown, Julie A

2013-04-01

Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME. This new approach does not just teach new information but also provides support for improvements where needed most within practice systems based on targeted data-based on self-assessments for the entire system of care. Joslin data conclude that this new approach will benefit support, clinical, and office teams as well as the specialist. In short, the Performance Improvement CME structure reflects the needed components of the successful practice today, particularly for chronic conditions such as diabetes, including the focus on interdisciplinary team care and on quality improvement, which is becoming more and more aligned with reimbursement schemes, public and private, in the U.S. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Significant improvement of the quality of bystander first aid using an expert system with a mobile multimedia device.

PubMed

Ertl, Lorenz; Christ, Frank

2007-08-01

Better quality bystander first-aid could improve outcome rates for emergency victims significantly. In this case-control study, we hypothesised that expert knowledge presented step-by-step to untrained helpers using a personal digital assistant (PDA), would improve the quality of bystanders basic life support. We confronted 101 lay-helpers with two standard emergency situations. (1) An unconscious trauma victim with severe bleeding. (2) Cardiopulmonary resuscitation (CPR). Performance was assessed using an Objective Structured Clinical Examination (OSCE). One group was supported by a PDA providing visual and audio instructions, whereas the control group acted only with their current knowledge. The expert system was programmed in HTML-code and displayed on the PDA's Internet browser. The maximum score obtainable was 24 points corresponding to optimal treatment. The control group without the PDA reached 14.8+/-3.5 (mean value+/-standard deviation), whereas the PDA supported group scored significantly higher (21.9+/-2.7, p<0.01). The difference in performance was measurable in all criteria tested and particularly notable in the items: placing in recovery position, airway management and quality of CPR. The PDA based expert system increased the performance of untrained helpers supplying emergency care significantly. Since Internet compatible mobile devices have become widely available, a significant quality improvement in bystander first-aid seems possible.

Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

PubMed Central

Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

2012-01-01

The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed. PMID:25945193

Smart information system for gachon university gil hospital.

PubMed

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Smart Information System for Gachon University Gil Hospital

PubMed Central

Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-01-01

Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

Unmanned aircraft systems for transportation decision support.

DOT National Transportation Integrated Search

2016-11-30

Our nation relies on accurate geospatial information to map, measure, and monitor transportation infrastructure and the surrounding landscapes. This project focused on the application of Unmanned Aircraft systems (UAS) as a novel tool for improving e...

The Commercial Vehicle Information Systems and Network program, 2012.

DOT National Transportation Integrated Search

2014-03-01

The Commercial Vehicle Information Systems and : Networks (CVISN) program supports that safety : mission by providing grant funds to States for: : Improving safety and productivity of motor : carriers, commercial motor vehicles : (CMVs), and thei...

Agroforestry

USDA-ARS?s Scientific Manuscript database

The impacts of agroforestry systems (AFS) on soil management in temperate, subtropical, and tropical biomes support the beneficial, holistic role of tree components in agricultural land-use systems. Compared to annual monocultures, AFS can enhance several soil physical properties improving soil resi...

The commercial vehicle information systems and networks program, 2013.

DOT National Transportation Integrated Search

2015-04-01

The Commercial Vehicle Information Systems and Networks (CVISN) grant program supports the Federal Motor Carrier Safety Administrations (FMCSAs) safety mission by providing grant funds to States to: : Improve safety and productivity of moto...

Agency for Healthcare Research and Quality

MedlinePlus

... improve patient outcomes Opioids Supporting HHS' Opioid Initiative Comparative Health System Performance Initiative AHRQ Releases Compendium of ... the U.S. Health system. More AHRQ IMPACT CASE STUDIES AHRQ’s evidence-based tools and resources are used ...

Computer-supported feedback message tailoring: theory-informed adaptation of clinical audit and feedback for learning and behavior change.

PubMed

Landis-Lewis, Zach; Brehaut, Jamie C; Hochheiser, Harry; Douglas, Gerald P; Jacobson, Rebecca S

2015-01-21

Evidence shows that clinical audit and feedback can significantly improve compliance with desired practice, but it is unclear when and how it is effective. Audit and feedback is likely to be more effective when feedback messages can influence barriers to behavior change, but barriers to change differ across individual health-care providers, stemming from differences in providers' individual characteristics. The purpose of this article is to invite debate and direct research attention towards a novel audit and feedback component that could enable interventions to adapt to barriers to behavior change for individual health-care providers: computer-supported tailoring of feedback messages. We argue that, by leveraging available clinical data, theory-informed knowledge about behavior change, and the knowledge of clinical supervisors or peers who deliver feedback messages, a software application that supports feedback message tailoring could improve feedback message relevance for barriers to behavior change, thereby increasing the effectiveness of audit and feedback interventions. We describe a prototype system that supports the provision of tailored feedback messages by generating a menu of graphical and textual messages with associated descriptions of targeted barriers to behavior change. Supervisors could use the menu to select messages based on their awareness of each feedback recipient's specific barriers to behavior change. We anticipate that such a system, if designed appropriately, could guide supervisors towards giving more effective feedback for health-care providers. A foundation of evidence and knowledge in related health research domains supports the development of feedback message tailoring systems for clinical audit and feedback. Creating and evaluating computer-supported feedback tailoring tools is a promising approach to improving the effectiveness of clinical audit and feedback.

Health policy and systems research training: global status and recommendations for action

PubMed Central

Tancred, Tara M; Schleiff, Meike; Peters, David H

2016-01-01

Abstract Objective To investigate the characteristics of health policy and systems research training globally and to identify recommendations for improvement and expansion. Methods We identified institutions offering health policy and systems research training worldwide. In 2014, we recruited participants from identified institutions for an online survey on the characteristics of the institutions and the courses given. Survey findings were explored during in-depth interviews with selected key informants. Findings The study identified several important gaps in health policy and systems research training. There were few courses in central and eastern Europe, the Middle East, North Africa or Latin America. Most (116/152) courses were instructed in English. Institutional support for courses was often lacking and many institutions lacked the critical mass of trained individuals needed to support doctoral and postdoctoral students. There was little consistency between institutions in definitions of the competencies required for health policy and systems research. Collaboration across disciplines to provide the range of methodological perspectives the subject requires was insufficient. Moreover, the lack of alternatives to on-site teaching may preclude certain student audiences such as policy-makers. Conclusion Training in health policy and systems research is important to improve local capacity to conduct quality research in this field. We provide six recommendations to improve the content, accessibility and reach of training. First, create a repository of information on courses. Second, establish networks to support training. Third, define competencies in health policy and systems research. Fourth, encourage multidisciplinary collaboration. Fifth, expand the geographical and language coverage of courses. Finally, consider alternative teaching formats. PMID:27429488

45 CFR 1355.53 - Conditions for approval of funding.

Code of Federal Regulations, 2010 CFR

2010-10-01

... title IV-A, (ii) National Child Abuse and Neglect Data Systems (NCANDS), (iii) Systems operated under title XIX, and (iv) Systems operated under title IV-D; (3) Support the provisions of section 422(a) by... system, which is effective and efficient, to improve the program management and administration of the...

Annual Report in Support of Technical Development Plan 43-03X--Education and Training Development. Annual Report No. 4, November 11, 1972--November 15, 1973 on Phase 2.

ERIC Educational Resources Information Center

Marlowe, Edward; And Others

This is the fourth report in a series which describes the results and progress in a long-term program to develop a Data Management System (DMS) and a Student Management System (SMS) for use in the Naval Student Pilot Training System. The DMS will contain all of the student naval aviator's data files needed to support an improved student training…

[Supporting the intermediate level of health care in urban health areas in Kinshasa (1995-2005), DR Congo].

PubMed

Mbeva, Jean-Bosco Kahindo; Schirvel, Carole; Karemere, Hermès; Porignon, Denis

2012-06-08

As a result of the decentralization of health systems, some countries have introduced intermediate (provincial) levels in their public health system. This paper presents the results of a case study conducted in Kinshasa on health system decentralization. The study identified a shift from a focus on regulation compliance assessment to an emphasis on health system coordination and health district support. It also highlighted the emergence of a?managerial (as opposed to a bureaucratic) approach to health district support. The performance of health districts in terms of health care coverage and health service use were also found to have improved. The results highlight the importance of intermediate levels in?the health care system and the value of a more organic and managerial rationality in supporting health districts faced with the complexity of urban environments and the integration of specialized multi-partner programs and interventions.

Rejuvenation of Spent Media via Supported Emulsion Liquid Membranes

NASA Technical Reports Server (NTRS)

Wiencek, John M.

2002-01-01

The overall goal of this project was to maximize the reuseability of spent fermentation media. Supported emulsion liquid membrane separation, a highly efficient extraction technique, was used to remove inhibitory byproducts during fermentation; thus, improve the yield while reducing the need for fresh water. The key objectives of this study were: (1) Develop an emulsion liquid membrane system targeting low molecular weight organic acids which has minimal toxicity on a variety of microbial systems. (2) Conduct mass transfer studies to allow proper modeling and design of a supported emulsion liquid membrane system. (3) Investigate the effect of gravity on emulsion coalescence within the membrane unit. (4) Access the effect of water re-use on fermentation yields in a model microbial system. and (5) Develop a perfusion-type fermentor utilizing a supported emulsion liquid membrane system to control inhibitory fermentation byproducts (not completed due to lack of funds)

Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

ERIC Educational Resources Information Center

National Center for Systemic Improvement at WestEd, 2015

2015-01-01

This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

Designing Effective School Improvement Strategies. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2009

2009-01-01

Across the country, educators in schools that have not met their targets for improved student learning are considering next steps. As a first step, a school improvement plan that is grounded in data and based on a comprehensive needs assessment can provide a framework for effecting change for a school's programming, student support systems, and…

Can Teacher Evaluation Improve Teaching?

ERIC Educational Resources Information Center

Principal Leadership, 2013

2013-01-01

The answer to the question, Can evaluation improve teaching? is a qualified yes. Teacher evaluation has changed and the role of the principal has changed as well; the focus now is on evidence, not merely good judgment. With the right tools, systems, and support, it should be possible to help improve teaching performance and student learning…

Design and Analysis of a Flexible, Reliable Deep Space Life Support System

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2012-01-01

This report describes a flexible, reliable, deep space life support system design approach that uses either storage or recycling or both together. The design goal is to provide the needed life support performance with the required ultra reliability for the minimum Equivalent System Mass (ESM). Recycling life support systems used with multiple redundancy can have sufficient reliability for deep space missions but they usually do not save mass compared to mixed storage and recycling systems. The best deep space life support system design uses water recycling with sufficient water storage to prevent loss of crew if recycling fails. Since the amount of water needed for crew survival is a small part of the total water requirement, the required amount of stored water is significantly less than the total to be consumed. Water recycling with water, oxygen, and carbon dioxide removal material storage can achieve the high reliability of full storage systems with only half the mass of full storage and with less mass than the highly redundant recycling systems needed to achieve acceptable reliability. Improved recycling systems with lower mass and higher reliability could perform better than systems using storage.

A domains-based taxonomy of supported accommodation for people with severe and persistent mental illness.

PubMed

Siskind, Dan; Harris, Meredith; Pirkis, Jane; Whiteford, Harvey

2013-06-01

A lack of definitional clarity in supported accommodation and the absence of a widely accepted system for classifying supported accommodation models creates barriers to service planning and evaluation. We undertook a systematic review of existing supported accommodation classification systems. Using a structured system for qualitative data analysis, we reviewed the stratification features in these classification systems, identified the key elements of supported accommodation and arranged them into domains and dimensions to create a new taxonomy. The existing classification systems were mapped onto the new taxonomy to verify the domains and dimensions. Existing classification systems used either a service-level characteristic or programmatic approach. We proposed a taxonomy based around four domains: duration of tenure; patient characteristics; housing characteristics; and service characteristics. All of the domains in the taxonomy were drawn from the existing classification structures; however, none of the existing classification structures covered all of the domains in the taxonomy. Existing classification systems are regionally based, limited in scope and lack flexibility. A domains-based taxonomy can allow more accurate description of supported accommodation services, aid in identifying the service elements likely to improve outcomes for specific patient populations, and assist in service planning.

Dynamic load-sharing characteristic analysis of face gear power-split gear system based on tooth contact characteristics

NASA Astrophysics Data System (ADS)

Dong, Hao; Hu, Yahui

2018-04-01

The bend-torsion coupling dynamics load-sharing model of the helicopter face gear split torque transmission system is established by using concentrated quality standard, to analyzing the dynamic load-sharing characteristic. The mathematical models include nonlinear support stiffness, time-varying meshing stiffness, damping, gear backlash. The results showed that the errors collectively influenced the load sharing characteristics, only reduce a certain error, it is never fully reached the perfect loading sharing characteristics. The system load-sharing performance can be improved through floating shaft support. The above-method will provide a theoretical basis and data support for its dynamic performance optimization design.

WISE: Automated support for software project management and measurement. M.S. Thesis

NASA Technical Reports Server (NTRS)

Ramakrishnan, Sudhakar

1995-01-01

One important aspect of software development and IV&V is measurement. Unless a software development effort is measured in some way, it is difficult to judge the effectiveness of current efforts and predict future performances. Collection of metrics and adherence to a process are difficult tasks in a software project. Change activity is a powerful indicator of project status. Automated systems that can handle change requests, issues, and other process documents provide an excellent platform for tracking the status of the project. A World Wide Web based architecture is developed for (a) making metrics collection an implicit part of the software process, (b) providing metric analysis dynamically, (c) supporting automated tools that can complement current practices of in-process improvement, and (d) overcoming geographical barrier. An operational system (WISE) instantiates this architecture allowing for the improvement of software process in a realistic environment. The tool tracks issues in software development process, provides informal communication between the users with different roles, supports to-do lists (TDL), and helps in software process improvement. WISE minimizes the time devoted to metrics collection, analysis, and captures software change data. Automated tools like WISE focus on understanding and managing the software process. The goal is improvement through measurement.

Improved satellite and geospatial tools for pipeline operator decision support systems.

DOT National Transportation Integrated Search

2017-01-06

Under Cooperative Agreement No. OASRTRS-14-H-CAL, California Polytechnic State University San Luis Obispo (Cal Poly), partnered with C-CORE, MDA, PRCI, and Electricore to design and develop improved satellite and geospatial tools for pipeline operato...

Report: EPA’s Fleet Management Program Needs Improvement

EPA Pesticide Factsheets

Report #15-P-0001, October 6, 2014. If oversight of the EPA’s fleet is not improved, the $6 million-per-year program could be ineffective and inefficient in supporting the agency’s mission and reporting data to the federal system.

Right Ventricular Failure Post LVAD Implantation Corrected with Biventricular Support: An In Vitro Model.

PubMed

Shehab, Sajad; Allida, Sabine M; Davidson, Patricia M; Newton, Phillip J; Robson, Desiree; Jansz, Paul C; Hayward, Christopher S

Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system. Our hypothesis was that delayed continuous flow RVAD (RVAD) would produce similar hemodynamic and flow parameters to those of initial BiVAD support. Using the MCL, baseline biventricular heart failure with elevated right and left filling pressures with low cardiac output was simulated. The addition of LVAD within a biventricular configuration improved cardiac output somewhat, but was associated with persistent right heart failure with elevated right-sided filling pressures. The addition of an RVAD significantly improved LVAD outputs and returned filling pressures to normal throughout the circulation. In conclusion, RVAD support successfully restored hemodynamics and flow parameters of biventricular failure supported with isolated LVAD with persistent elevated right atrial pressure.

Evaluation of a dynamic arm support for seated and standing tasks: a laboratory study of electromyography and subjective feedback.

PubMed

Odell, Dan; Barr, Alan; Goldberg, Robert; Chung, Jeffrey; Rempel, David

2007-04-01

The goal of this study was to determine whether a new dynamic arm support system reduced shoulder and arm muscle load for seated and standing hand/ arm tasks. The new system provides support for both horizontal and vertical arm motion. A total of 11 participants performed ten tasks (five seated and five standing) both with and without the arm support. Outcomes were assessed with electromyography and subjective feedback. Muscle activity was measured over the dominant side supraspinatus, triceps and forearm extensor muscles. Significant (p < 0.01) reductions in static muscle activity were observed in one of ten tasks performed with the support device for the supraspinatus muscle, in five tasks for the triceps and in one task for forearm extensor muscles. Likewise, a significant improvement in subjective measures was reported with the support device for 'ease of task' for two of ten tasks, for 'forearm comfort' for three of ten tasks and for 'shoulder effort' for six of ten tasks. The results suggest that a dynamic forearm support may improve subjective comfort and reduce static muscle loads in the upper extremity for tasks that involve horizontal movement of the arms. For rapid motions, the value of the support is limited due to internal inertia and friction.

Space Shuttle Main Engine (SSME) Evolution

NASA Technical Reports Server (NTRS)

Worlund, Len A.; Hastings, J. H.; McCool, Alex (Technical Monitor)

2001-01-01

The SSME when developed in the 1970's was a technological leap in space launch propulsion system design. The engine has safely supported the space shuttle for the last two decades and will be required for at least another decade to support human space flight to the international space station. This paper discusses the continued improvements and maturing of the system to its current state and future considerations for its critical role in the nations space program. Discussed are the initiatives of the late 1980's, which lead to three major upgrades through the 1990's. The current capabilities of the propulsion system are defined in the areas of highest programmatic importance: ascent risk, in-flight abort thrust, reusability, and operability. Future initiatives for improved shuttle safety, the paramount priority of the Space Shuttle program are discussed.

Damping and support in high-temperature superconducting levitation systems

DOEpatents

Hull, John R [Sammamish, WA; McIver, Carl R [Everett, WA; Mittleider, John A [Kent, WA

2009-12-15

Methods and apparatuses to provide improved auxiliary damping for superconducting bearings in superconducting levitation systems are disclosed. In a superconducting bearing, a cryostat housing the superconductors is connected to a ground state with a combination of a damping strip of material, a set of linkage arms to provide vertical support, and spring washers to provide stiffness. Alternately, the superconducting bearing may be supported by a cryostat connected to a ground state by posts constructed from a mesh of fibers, with the damping and stiffness controlled by the fiber composition, size, and mesh geometry.

Strategic Use of Microscrews for Enhancing the Accuracy of Computer-Guided Implant Surgery in Fully Edentulous Arches: A Case History Report.

PubMed

Lee, Du-Hyeong

Implant guide systems can be classified by their supporting structure as tooth-, mucosa-, or bone-supported. Mucosa-supported guides for fully edentulous arches show lower accuracy in implant placement because of errors in image registration and guide positioning. This article introduces the application of a novel microscrew system for computer-aided implant surgery. This technique can markedly improve the accuracy of computer-guided implant surgery in fully edentulous arches by eliminating errors from image fusion and guide positioning.

Increasing Fleet Readiness Through Improved Distance Support

DTIC Science & Technology

2013-03-01

gis tic s D ata Pro ce ss  Tra ini ng  Da ta An aly ze  Da ta An...Format Fleet Maintenance Formatted Data /sData F.2.2 • ... Fleet Support Infrastructure Data ~ Formatted Trainin~ ata l Obtain and Format Fleet...system either by using a form or a spreadsheet F.2.2 Obtain Data from Fleet Recorded System Performance Data is downloaded from ship either manually

New technologies emerge.

PubMed

Gray, S P

1997-01-01

Technology vendors continue to invent new devices, systems and processes to sell to the health care industry. Drugs, instruments and procedures continue to improve and address disease and injury treatment needs. In addition to these direct medical treatment innovations and enhancements, a number of new supporting systems and products have emerged. These support technologies hold significant promise for managers to make day-to-day execution of health care delivery more cost effective and customer friendly.

Computer systems to support census geography.

PubMed

Deecker, G; Cunningham, R; Kidd, K

1986-01-01

The development of computer systems that support the geography of the census in Canada is described. The authors "present proposals for the 1991 Census that increase the level of automation, whether the geography changes or not. In addition, opportunities for change and improvement, should the geography change, are outlined. To minimize the risks involved, it is important to give these different proposals serious consideration early in the planning of a census." excerpt

Using Pilots to Assess the Value and Approach of CMMI Implementation

NASA Technical Reports Server (NTRS)

Godfrey, Sara; Andary, James; Rosenberg, Linda

2002-01-01

At Goddard Space Flight Center (GSFC), we have chosen to use Capability Maturity Model Integrated (CMMI) to guide our process improvement program. Projects at GSFC consist of complex systems of software and hardware that control satellites, operate ground systems, run instruments, manage databases and data and support scientific research. It is a challenge to launch a process improvement program that encompasses our diverse systems, yet is manageable in terms of cost effectiveness. In order to establish the best approach for improvement, our process improvement effort was divided into three phases: 1) Pilot projects; 2) Staged implementation; and 3) Sustainment and continual improvement. During Phase 1 the focus of the activities was on a baselining process, using pre-appraisals in order to get a baseline for making a better cost and effort estimate for the improvement effort. Pilot pre-appraisals were conducted from different perspectives so different approaches for process implementation could be evaluated. Phase 1 also concentrated on establishing an improvement infrastructure and training of the improvement teams. At the time of this paper, three pilot appraisals have been completed. Our initial appraisal was performed in a flight software area, considering the flight software organization as the organization. The second appraisal was done from a project perspective, focusing on systems engineering and acquisition, and using the organization as GSFC. The final appraisal was in a ground support software area, again using GSFC as the organization. This paper will present our initial approach, lessons learned from all three pilots and the changes in our approach based on the lessons learned.

RTEMS SMP and MTAPI for Efficient Multi-Core Space Applications on LEON3/LEON4 Processors

NASA Astrophysics Data System (ADS)

Cederman, Daniel; Hellstrom, Daniel; Sherrill, Joel; Bloom, Gedare; Patte, Mathieu; Zulianello, Marco

2015-09-01

This paper presents the final result of an European Space Agency (ESA) activity aimed at improving the software support for LEON processors used in SMP configurations. One of the benefits of using a multicore system in a SMP configuration is that in many instances it is possible to better utilize the available processing resources by load balancing between cores. This however comes with the cost of having to synchronize operations between cores, leading to increased complexity. While in an AMP system one can use multiple instances of operating systems that are only uni-processor capable, a SMP system requires the operating system to be written to support multicore systems. In this activity we have improved and extended the SMP support of the RTEMS real-time operating system and ensured that it fully supports the multicore capable LEON processors. The targeted hardware in the activity has been the GR712RC, a dual-core core LEON3FT processor, and the functional prototype of ESA's Next Generation Multiprocessor (NGMP), a quad core LEON4 processor. The final version of the NGMP is now available as a product under the name GR740. An implementation of the Multicore Task Management API (MTAPI) has been developed as part of this activity to aid in the parallelization of applications for RTEMS SMP. It allows for simplified development of parallel applications using the task-based programming model. An existing space application, the Gaia Video Processing Unit, has been ported to RTEMS SMP using the MTAPI implementation to demonstrate the feasibility and usefulness of multicore processors for space payload software. The activity is funded by ESA under contract 4000108560/13/NL/JK. Gedare Bloom is supported in part by NSF CNS-0934725.

Drivers' communicative interactions: on-road observations and modelling for integration in future automation systems.

PubMed

Portouli, Evangelia; Nathanael, Dimitris; Marmaras, Nicolas

2014-01-01

Social interactions with other road users are an essential component of the driving activity and may prove critical in view of future automation systems; still up to now they have received only limited attention in the scientific literature. In this paper, it is argued that drivers base their anticipations about the traffic scene to a large extent on observations of social behaviour of other 'animate human-vehicles'. It is further argued that in cases of uncertainty, drivers seek to establish a mutual situational awareness through deliberate communicative interactions. A linguistic model is proposed for modelling these communicative interactions. Empirical evidence from on-road observations and analysis of concurrent running commentary by 25 experienced drivers support the proposed model. It is suggested that the integration of a social interactions layer based on illocutionary acts in future driving support and automation systems will improve their performance towards matching human driver's expectations. Practitioner Summary: Interactions between drivers on the road may play a significant role in traffic coordination. On-road observations and running commentaries are presented as empirical evidence to support a model of such interactions; incorporation of drivers' interactions in future driving support and automation systems may improve their performance towards matching driver's expectations.

Nonlinear transient analysis of multi-mass flexible rotors - theory and applications

NASA Technical Reports Server (NTRS)

Kirk, R. G.; Gunter, E. J.

1973-01-01

The equations of motion necessary to compute the transient response of multi-mass flexible rotors are formulated to include unbalance, rotor acceleration, and flexible damped nonlinear bearing stations. A method of calculating the unbalance response of flexible rotors from a modified Myklestad-Prohl technique is discussed in connection with the method of solution for the transient response. Several special cases of simplified rotor-bearing systems are presented and analyzed for steady-state response, stability, and transient behavior. These simplified rotor models produce extensive design information necessary to insure stable performance to elastic mounted rotor-bearing systems under varying levels and forms of excitation. The nonlinear journal bearing force expressions derived from the short bearing approximation are utilized in the study of the stability and transient response of the floating bush squeeze damper support system. Both rigid and flexible rotor models are studied, and results indicate that the stability of flexible rotors supported by journal bearings can be greatly improved by the use of squeeze damper supports. Results from linearized stability studies of flexible rotors indicate that a tuned support system can greatly improve the performance of the units from the standpoint of unbalanced response and impact loading. Extensive stability and design charts may be readily produced for given rotor specifications by the computer codes presented in this analysis.

Artificial Intelligence Support for Computational Chemistry

NASA Astrophysics Data System (ADS)

Duch, Wlodzislaw

Possible forms of artificial intelligence (AI) support for quantum chemistry are discussed. Questions addressed include: what kind of support is desirable, what kind of support is feasible, what can we expect in the coming years. Advantages and disadvantages of current AI techniques are presented and it is argued that at present the memory-based systems are the most effective for large scale applications. Such systems may be used to predict the accuracy of calculations and to select the least expensive methods and basis sets belonging to the same accuracy class. Advantages of the Feature Space Mapping as an improvement on the memory based systems are outlined and some results obtained in classification problems given. Relevance of such classification systems to computational chemistry is illustrated with two examples showing similarity of results obtained by different methods that take electron correlation into account.

Enhancement of the EPA Stormwater BMP Decision-Support Tool (SUSTAIN) - slides

EPA Science Inventory

U.S. Environmental Protection Agency (EPA) has been developing and improving a decision-support tool for placement of stormwater best management practices (BMPs) at strategic locations in urban watersheds. The tool is called the System for Urban Stormwater Treatment and Analysis...

Driving out errors through tight integration between software and automation.

PubMed

Reifsteck, Mark; Swanson, Thomas; Dallas, Mary

2006-01-01

A clear case has been made for using clinical IT to improve medication safety, particularly bar-code point-of-care medication administration and computerized practitioner order entry (CPOE) with clinical decision support. The equally important role of automation has been overlooked. When the two are tightly integrated, with pharmacy information serving as a hub, the distinctions between software and automation become blurred. A true end-to-end medication management system drives out errors from the dockside to the bedside. Presbyterian Healthcare Services in Albuquerque has been building such a system since 1999, beginning by automating pharmacy operations to support bar-coded medication administration. Encouraged by those results, it then began layering on software to further support clinician workflow and improve communication, culminating with the deployment of CPOE and clinical decision support. This combination, plus a hard-wired culture of safety, has resulted in a dramatically lower mortality and harm rate that could not have been achieved with a partial solution.

Design of Clinical Support Systems Using Integrated Genetic Algorithm and Support Vector Machine

NASA Astrophysics Data System (ADS)

Chen, Yung-Fu; Huang, Yung-Fa; Jiang, Xiaoyi; Hsu, Yuan-Nian; Lin, Hsuan-Hung

Clinical decision support system (CDSS) provides knowledge and specific information for clinicians to enhance diagnostic efficiency and improving healthcare quality. An appropriate CDSS can highly elevate patient safety, improve healthcare quality, and increase cost-effectiveness. Support vector machine (SVM) is believed to be superior to traditional statistical and neural network classifiers. However, it is critical to determine suitable combination of SVM parameters regarding classification performance. Genetic algorithm (GA) can find optimal solution within an acceptable time, and is faster than greedy algorithm with exhaustive searching strategy. By taking the advantage of GA in quickly selecting the salient features and adjusting SVM parameters, a method using integrated GA and SVM (IGS), which is different from the traditional method with GA used for feature selection and SVM for classification, was used to design CDSSs for prediction of successful ventilation weaning, diagnosis of patients with severe obstructive sleep apnea, and discrimination of different cell types form Pap smear. The results show that IGS is better than methods using SVM alone or linear discriminator.

Workflow computing. Improving management and efficiency of pathology diagnostic services.

PubMed

Buffone, G J; Moreau, D; Beck, J R

1996-04-01

Traditionally, information technology in health care has helped practitioners to collect, store, and present information and also to add a degree of automation to simple tasks (instrument interfaces supporting result entry, for example). Thus commercially available information systems do little to support the need to model, execute, monitor, coordinate, and revise the various complex clinical processes required to support health-care delivery. Workflow computing, which is already implemented and improving the efficiency of operations in several nonmedical industries, can address the need to manage complex clinical processes. Workflow computing not only provides a means to define and manage the events, roles, and information integral to health-care delivery but also supports the explicit implementation of policy or rules appropriate to the process. This article explains how workflow computing may be applied to health-care and the inherent advantages of the technology, and it defines workflow system requirements for use in health-care delivery with special reference to diagnostic pathology.

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

PubMed

Piette, John D; Lun, K C; Moura, Lincoln A; Fraser, Hamish S F; Mechael, Patricia N; Powell, John; Khoja, Shariq R

2012-05-01

E-health encompasses a diverse set of informatics tools that have been designed to improve public health and health care. Little information is available on the impacts of e-health programmes, particularly in low- and middle-income countries. We therefore conducted a scoping review of the published and non-published literature to identify data on the effects of e-health on health outcomes and costs. The emphasis was on the identification of unanswered questions for future research, particularly on topics relevant to low- and middle-income countries. Although e-health tools supporting clinical practice have growing penetration globally, there is more evidence of benefits for tools that support clinical decisions and laboratory information systems than for those that support picture archiving and communication systems. Community information systems for disease surveillance have been implemented successfully in several low- and middle-income countries. Although information on outcomes is generally lacking, a large project in Brazil has documented notable impacts on health-system efficiency. Meta-analyses and rigorous trials have documented the benefits of text messaging for improving outcomes such as patients' self-care. Automated telephone monitoring and self-care support calls have been shown to improve some outcomes of chronic disease management, such as glycaemia and blood pressure control, in low- and middle-income countries. Although large programmes for e-health implementation and research are being conducted in many low- and middle-income countries, more information on the impacts of e-health on outcomes and costs in these settings is still needed.

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

PubMed Central

Lun, KC; Moura, Lincoln A; Fraser, Hamish SF; Mechael, Patricia N; Powell, John; Khoja, Shariq R

2012-01-01

Abstract E-health encompasses a diverse set of informatics tools that have been designed to improve public health and health care. Little information is available on the impacts of e-health programmes, particularly in low- and middle-income countries. We therefore conducted a scoping review of the published and non-published literature to identify data on the effects of e-health on health outcomes and costs. The emphasis was on the identification of unanswered questions for future research, particularly on topics relevant to low- and middle-income countries. Although e-health tools supporting clinical practice have growing penetration globally, there is more evidence of benefits for tools that support clinical decisions and laboratory information systems than for those that support picture archiving and communication systems. Community information systems for disease surveillance have been implemented successfully in several low- and middle-income countries. Although information on outcomes is generally lacking, a large project in Brazil has documented notable impacts on health-system efficiency. Meta-analyses and rigorous trials have documented the benefits of text messaging for improving outcomes such as patients’ self-care. Automated telephone monitoring and self-care support calls have been shown to improve some outcomes of chronic disease management, such as glycaemia and blood pressure control, in low- and middle-income countries. Although large programmes for e-health implementation and research are being conducted in many low- and middle-income countries, more information on the impacts of e-health on outcomes and costs in these settings is still needed. PMID:22589570

The Role of Crop Systems Simulation in Agriculture and Environment

USDA-ARS?s Scientific Manuscript database

Over the past 30 to 40 years, simulation of crop systems has advanced from a neophyte science with inadequate computing power into a robust and increasingly accepted science supported by improved software, languages, development tools, and computer capabilities. Crop system simulators contain mathe...

Increased Rail Transit Vehicle Crashworthiness in Head-On Collisions. Volume III. Guidelines for Evaluation and Development of New Railcar Designs.

DOT National Transportation Integrated Search

1980-06-01

As systems manager for the Urban Mass Transportation Administration (UMTA) Rail System Supporting Technology Program, the Transportation Systems Center (TSC) is conducting research and development efforts directed toward the introduction of improved ...

Business Goes to School: How the Private Sector Can Improve K-12 Education. Education Outlook. No. 5

ERIC Educational Resources Information Center

Hess, Frederick M.

2007-01-01

This brief argues that the best way for businesses to help fix the education system is to stop backing a system that does not work, insist on accountability, and support entrepreneurs who will shake things up. It recommends five things that business can do to improve education. First, business has expertise in performance evaluation, human…

Fostering the Development of Critical Thinking Skills, and Reading Comprehension of Undergraduates Using a Web 2.0 Tool Coupled with a Learning System

ERIC Educational Resources Information Center

Mendenhall, Anne; Johnson, Tristan E.

2010-01-01

A social annotation model learning system (SAM-LS) was created using multiple instructional strategies thereby supporting the student in improving in critical thinking, critical writing and related literacy. There are four mechanisms in which the SAM-LS methodology is believed to improve learning and performance. These mechanisms include providing…

FINAL TECHNICAL REPORT FOR FORESTRY BIOFUEL STATEWIDE COLLABORATION CENTER (MICHIGAN)

DOE Office of Scientific and Technical Information (OSTI.GOV)

LaCourt, Donna M.; Miller, Raymond O.; Shonnard, David R.

A team composed of scientists from Michigan State University (MSU) and Michigan Technological University (MTU) assembled to better understand, document, and improve systems for using forest-based biomass feedstocks in the production of energy products within Michigan. Work was funded by a grant (DE-EE-0000280) from the U.S. Department of Energy (DOE) and was administered by the Michigan Economic Development Corporation (MEDC). The goal of the project was to improve the forest feedstock supply infrastructure to sustainably provide woody biomass for biofuel production in Michigan over the long-term. Work was divided into four broad areas with associated objectives: • TASK A: Developmore » a Forest-Based Biomass Assessment for Michigan – Define forest-based feedstock inventory, availability, and the potential of forest-based feedstock to support state and federal renewable energy goals while maintaining current uses. • TASK B: Improve Harvesting, Processing and Transportation Systems – Identify and develop cost, energy, and carbon efficient harvesting, processing and transportation systems. • TASK C: Improve Forest Feedstock Productivity and Sustainability – Identify and develop sustainable feedstock production systems through the establishment and monitoring of a statewide network of field trials in forests and energy plantations. • TASK D: Engage Stakeholders – Increase understanding of forest biomass production systems for biofuels by a broad range of stakeholders. The goal and objectives of this research and development project were fulfilled with key model deliverables including: 1) The Forest Biomass Inventory System (Sub-task A1) of feedstock inventory and availability and, 2) The Supply Chain Model (Sub-task B2). Both models are vital to Michigan’s forest biomass industry and support forecasting delivered cost, as well as carbon and energy balance. All of these elements are important to facilitate investor, operational and policy decisions. All other sub-tasks supported the development of these two tools either directly or by building out supporting information in the forest biomass supply chain. Outreach efforts have, and are continuing to get these user friendly models and information to decision makers to support biomass feedstock supply chain decisions across the areas of biomass inventory and availability, procurement, harvest, forwarding, transportation and processing. Outreach will continue on the project website at http://www.michiganforestbiofuels.org/ and http://www.michiganwoodbiofuels.org/« less

The Application of Auto-Disturbance Rejection Control Optimized by Least Squares Support Vector Machines Method and Time-Frequency Representation in Voltage Source Converter-High Voltage Direct Current System.

PubMed

Liu, Ying-Pei; Liang, Hai-Ping; Gao, Zhong-Ke

2015-01-01

In order to improve the performance of voltage source converter-high voltage direct current (VSC-HVDC) system, we propose an improved auto-disturbance rejection control (ADRC) method based on least squares support vector machines (LSSVM) in the rectifier side. Firstly, we deduce the high frequency transient mathematical model of VSC-HVDC system. Then we investigate the ADRC and LSSVM principles. We ignore the tracking differentiator in the ADRC controller aiming to improve the system dynamic response speed. On this basis, we derive the mathematical model of ADRC controller optimized by LSSVM for direct current voltage loop. Finally we carry out simulations to verify the feasibility and effectiveness of our proposed control method. In addition, we employ the time-frequency representation methods, i.e., Wigner-Ville distribution (WVD) and adaptive optimal kernel (AOK) time-frequency representation, to demonstrate our proposed method performs better than the traditional method from the perspective of energy distribution in time and frequency plane.

The Application of Auto-Disturbance Rejection Control Optimized by Least Squares Support Vector Machines Method and Time-Frequency Representation in Voltage Source Converter-High Voltage Direct Current System

PubMed Central

Gao, Zhong-Ke

2015-01-01

In order to improve the performance of voltage source converter-high voltage direct current (VSC-HVDC) system, we propose an improved auto-disturbance rejection control (ADRC) method based on least squares support vector machines (LSSVM) in the rectifier side. Firstly, we deduce the high frequency transient mathematical model of VSC-HVDC system. Then we investigate the ADRC and LSSVM principles. We ignore the tracking differentiator in the ADRC controller aiming to improve the system dynamic response speed. On this basis, we derive the mathematical model of ADRC controller optimized by LSSVM for direct current voltage loop. Finally we carry out simulations to verify the feasibility and effectiveness of our proposed control method. In addition, we employ the time-frequency representation methods, i.e., Wigner-Ville distribution (WVD) and adaptive optimal kernel (AOK) time-frequency representation, to demonstrate our proposed method performs better than the traditional method from the perspective of energy distribution in time and frequency plane. PMID:26098556

Data and knowledge in medical distributed applications.

PubMed

Serban, Alexandru; Crişan-Vida, Mihaela; Stoicu-Tivadar, Lăcrămioara

2014-01-01

Building a clinical decision support system (CDSS) capable to collect process and diagnose data from the patients automatically, based on information, symptoms and investigations is one of the current challenges for researchers and medical science. The purpose of the current study is to design a cloud-based CDSS to improve patient safety, quality of care and organizational efficiency. It presents the design of a cloud-based application system using a medical based approach, which covers different diseases to diagnosis, differentiated on most important pathologies. Using online questionnaires, traditional and new data will be collected from patients. After data input, the application will formulate a presumptive diagnosis and will direct patients to the correspondent department. A questionnaire will dynamically ask questions about the interface, and functionality improvements. Based on the answers, the functionality of the system and the user interface will be improved considering the real needs expressed by the end-users. The cloud-based CDSS, as a useful tool for patients, physicians and healthcare providers involves the computer support in the diagnosis of different pathologies and an accurate automatic differential diagnostic system.

Pediatric aspects of inpatient health information technology systems.

PubMed

Lehmann, Christoph U

2015-03-01

In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children. Copyright © 2015 by the American Academy of Pediatrics.

A decision support system for drinking water production integrating health risks assessment.

PubMed

Delpla, Ianis; Monteith, Donald T; Freeman, Chris; Haftka, Joris; Hermens, Joop; Jones, Timothy G; Baurès, Estelle; Jung, Aude-Valérie; Thomas, Olivier

2014-07-18

The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD). Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS) named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes) to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109). Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation.

Clinical decision support: effectiveness in improving quality processes and clinical outcomes and factors that may influence success.

PubMed

Murphy, Elizabeth V

2014-06-01

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the "meaningful use" of electronic medical record systems. An important component of the "Meaningful Use" legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledge and evidence-based guidance to the physician at the point of care. As reimbursement is increasingly tied to process and clinical outcomes, CDSS will be integral to future medical practice. Studies of CDSS indicate improvement in preventive services, appropriate care, and clinical and cost outcomes with strong evidence for CDSS effectiveness in process measures. Increasing provider adherence to CDSS recommendations is essential in improving CDSS effectiveness, and factors that influence adherence are currently under study.

Value impact assessment: A preliminary assessment of improvement opportunities at the Quantico Central Heating Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brambley, M.R.; Weakley, S.A.

1990-09-01

This report presents the results of a preliminary assessment of opportunities for improvement at the US Marine Corps (USMC) Quantico, Virginia, Central Heating Plant (CHP). This study is part of a program intended to provide the CHP staff with a computerized Artificial Intelligence (AI) decision support system that will assist in a more efficient, reliable, and safe operation of their plant. As part of the effort to provide the AI decision support system, a team of six scientists and engineers from the Pacific Northwest Laboratory (PNL) visited the plant to characterize the conditions and environment of the CHP. This assessmentmore » resulted in a list of potential performance improvement opportunities at the CHP. In this report, 12 of these opportunities are discussed and qualitatively analyzed. 70 refs., 7 figs., 6 tabs.« less

Implement the medical group revenue function. Create competitive advantage.

PubMed

Colucci, C

1998-01-01

This article shows medical groups how they can employ new financial management and information technology techniques to safeguard their revenue and income streams. These managerial techniques stem from the application of the medical group revenue function, which is defined herein. This article also describes how the medical group revenue function can be used to create value by employing a database and a decision support system. Finally, the article describes how the decision support system can be used to create competitive advantage. Through the wise use of internally generated information, medical groups can negotiate better contract terms, improve their operations, cut their costs, embark on capital investment programs and improve market share. As medical groups gain market power by improving in these areas, they will be more attractive to potential strategic allies, payers and investment bankers.

I/O Router Placement and Fine-Grained Routing on Titan to Support Spider II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ezell, Matthew A; Dillow, David; Oral, H Sarp

2014-01-01

The Oak Ridge Leadership Computing Facility (OLCF) introduced the concept of Fine-Grained Routing in 2008 to improve I/O performance between the Jaguar supercomputer and Spider, OLCF s center-wide Lustre file system. Fine-grained routing organizes I/O paths to minimize congestion. Jaguar has since been upgraded to Titan, providing more than a ten-fold improvement in peak performance. To support the center s increased computational capacity and I/O demand, the Spider file system has been replaced with Spider II. Building on the lessons learned from Spider, an improved method for placing LNET routers was developed and implemented for Spider II. The fine-grained routingmore » scripts and configuration have been updated to provide additional optimizations and better match the system setup. This paper presents a brief history of fine-grained routing at OLCF, an introduction to the architectures of Titan and Spider II, methods for placing routers in Titan, and details about the fine-grained routing configuration.« less

Evaluation of artillery equipment maintenance support capability based on grey clustering

NASA Astrophysics Data System (ADS)

Zhai, Mei-jie; Gao, Peng

2017-12-01

This paper, the theory and method of evaluating the capability of equipment maintenance support in China and abroad are studied, from the point of view of the combat task of artillery troops and the strategic attachment in the future military struggle. This paper establishes the framework of the evaluation Index system of the equipment maintenance support capability of the artillery units, and applies the grey clustering method to the evaluation of the equipment maintenance support capability of the artillery units, and finally evaluates the equipment maintenance and support capability of the artillery brigade as an example, and analyzes the evaluation results. This paper finds out the outstanding problems existing in the maintenance and support of military equipment, and puts forward some constructive suggestions, in order to improve the status of military equipment maintenance and support and improve the level of future equipment maintenance.

Mines Systems Safety Improvement Using an Integrated Event Tree and Fault Tree Analysis

NASA Astrophysics Data System (ADS)

Kumar, Ranjan; Ghosh, Achyuta Krishna

2017-04-01

Mines systems such as ventilation system, strata support system, flame proof safety equipment, are exposed to dynamic operational conditions such as stress, humidity, dust, temperature, etc., and safety improvement of such systems can be done preferably during planning and design stage. However, the existing safety analysis methods do not handle the accident initiation and progression of mine systems explicitly. To bridge this gap, this paper presents an integrated Event Tree (ET) and Fault Tree (FT) approach for safety analysis and improvement of mine systems design. This approach includes ET and FT modeling coupled with redundancy allocation technique. In this method, a concept of top hazard probability is introduced for identifying system failure probability and redundancy is allocated to the system either at component or system level. A case study on mine methane explosion safety with two initiating events is performed. The results demonstrate that the presented method can reveal the accident scenarios and improve the safety of complex mine systems simultaneously.

Greater Yellowstone regional traveler and weather information system evaluation plan

DOT National Transportation Integrated Search

2002-04-19

The ITS Integration Program is being conducted to accelerate the integration and interoperability of intelligent transportation systems in metropolitan and rural areas. Projects approved for funding have been assessed as supporting the improvements o...

Flexible solution for interoperable cloud healthcare systems.

PubMed

Vida, Mihaela Marcella; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara; Bernad, Elena

2012-01-01

It is extremely important for the healthcare domain to have a standardized communication because will improve the quality of information and in the end the resulting benefits will improve the quality of patients' life. The standards proposed to be used are: HL7 CDA and CCD. For a better access to the medical data a solution based on cloud computing (CC) is investigated. CC is a technology that supports flexibility, seamless care, and reduced costs of the medical act. To ensure interoperability between healthcare information systems a solution creating a Web Custom Control is presented. The control shows the database tables and fields used to configure the two standards. This control will facilitate the work of the medical staff and hospital administrators, because they can configure the local system easily and prepare it for communication with other systems. The resulted information will have a higher quality and will provide knowledge that will support better patient management and diagnosis.

Highlights of X-Stack ExM Deliverable: MosaStore

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ripeanu, Matei

2016-07-20

This brief report highlights the experience gained with MosaStore, an exploratory part of the X-Stack project “ExM: System support for extreme-scale, many-task applications”. The ExM project proposed to use concurrent workflows supported by the Swift language and runtime as an innovative programming model to exploit parallelism in exascale computers. MosaStore aims to support this endeavor by improving storage support for workflow-based applications, more precisely by exploring the gains that can be obtained from co-designing the storage system and the workflow runtime engine. MosaStore has been developed primarily at the University of British Columbia.

A Community of Practice Approach to Support for Ninth-Graders in Urban High Schools. Policy Brief

ERIC Educational Resources Information Center

Legters, Nettie; Parise, Leigh

2016-01-01

Providing ninth-graders with academic and social support can put more students on the graduation path, but it can be challenging for schools and school systems to implement that support routinely and effectively. This brief describes how Broward County Public Schools adopted a community of practice (CoP) approach to improve school-based teams'…

Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project.

PubMed

Livingston, James D; Nijdam-Jones, Alicia; Lapsley, Sara; Calderwood, Colleen; Brink, Johann

2013-01-01

Mental health services are shifting toward approaches that promote patients' choices and acknowledge the value of their lived experiences. To support patients' recovery and improve their experiences of care in a Canadian forensic mental health hospital, an intervention was launched to increase patient engagement by establishing a peer support program, strengthening a patient advisory committee, and creating a patient-led research team. The effect of the intervention on patient- and system-level outcomes was studied using a naturalistic, prospective, longitudinal approach. Quantitative and qualitative data were gathered from inpatients and service providers twice during the 19-month intervention. Despite succeeding in supporting patients' participation, the intervention had minimal impacts on internalized stigma, personal recovery, personal empowerment, service engagement, therapeutic milieu, and the recovery orientation of services. Peer support demonstrated positive effects on internalized stigma and personal recovery. Strengthening patient engagement contributes toward improving experiences of care in a forensic hospital, but it may have limited effects on outcomes.

Improving Interlaminar Shear Strength

NASA Technical Reports Server (NTRS)

Jackson, Justin

2015-01-01

To achieve NASA's mission of space exploration, innovative manufacturing processes are being applied to the fabrication of complex propulsion elements.1 Use of fiber-reinforced, polymeric composite tanks are known to reduce weight while increasing performance of propulsion vehicles. Maximizing the performance of these materials is needed to reduce the hardware weight to result in increased performance in support of NASA's missions. NASA has partnered with the Mississippi State University (MSU) to utilize a unique scalable approach of locally improving the critical properties needed for composite structures. MSU is responsible for the primary development of the concept with material and engineering support provided by NASA. The all-composite tank shown in figure 1 is fabricated using a prepreg system of IM7 carbon fiber/CYCOM 5320-1 epoxy resin. This is a resin system developed for out-of-autoclave applications. This new technology is needed to support the fabrication of large, all composite structures and is currently being evaluated on a joint project with Boeing for the Space Launch System (SLS) program. In initial efforts to form an all composite pressure vessel using this prepreg system, a 60% decrease in properties was observed in scarf joint regions. Inspection of these areas identified interlaminar failure in the adjacent laminated structure as the main failure mechanism. This project seeks to improve the interlaminar shear strength (ILSS) within the prepreg layup by locally modifying the interply region shown in figure 2.2

NASA Advanced Explorations Systems: 2017 Advancements in Life Support Systems

NASA Technical Reports Server (NTRS)

Schneider, Walter F.; Shull, Sarah A.

2017-01-01

The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions planned in the mid-2020s and beyond. The LSS Project is focused on four are-as-architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the International Space Station (ISS) LSS systems as a point of departure where applicable, the three-fold mission of the LSS Project is to address discrete LSS technology gaps, to improve the reliability of LSS systems, and to advance LSS systems toward integrated testing aboard the ISS. This paper is a follow on to the AES LSS development status reported in 2016 and provides additional details on the progress made since that paper was published with specific attention to the status of the Aerosol Sampler ISS Flight Experiment, the Spacecraft Atmosphere Monitor (SAM) Flight Experiment, the Brine Processor Assembly (BPA) Flight Experiment, the CO2 removal technology development tasks, and the work investigating the impacts of dormancy on LSS systems.

Advanced Technologies to Improve Closure of Life Support Systems

NASA Technical Reports Server (NTRS)

Barta, Daniel J.

2016-01-01

As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Candidate technologies will potentially improve the recovery of oxygen from about 50% (for the CRA) to as much as 100% for technologies who's end product is solid carbon. Improving the efficiency of water recycling and recovery can be achieved by the addition of advanced technologies to recover water from brines and solid wastes. Bioregenerative technologies may be utilized for water reclaimation and also for the production of food. Use of higher plants will simultaneously benefit atmosphere revitalization and water recovery through photosynthesis and transpiration. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.

Automation, decision support, and expert systems in nephrology.

PubMed

Soman, Sandeep; Zasuwa, Gerard; Yee, Jerry

2008-01-01

Increasing data suggest that errors in medicine occur frequently and result in substantial harm to the patient. The Institute of Medicine report described the magnitude of the problem, and public interest in this issue, which was already large, has grown. The traditional approach in medicine has been to identify the persons making the errors and recommend corrective strategies. However, it has become increasingly clear that it is more productive to focus on the systems and processes through which care is provided. If these systems are set up in ways that would both make errors less likely and identify those that do occur and, at the same time, improve efficiency, then safety and productivity would be substantially improved. Clinical decision support systems (CDSSs) are active knowledge systems that use 2 or more items of patient data to generate case specific recommendations. CDSSs are typically designed to integrate a medical knowledge base, patient data, and an inference engine to generate case specific advice. This article describes how automation, templating, and CDSS improve efficiency, patient care, and safety by reducing the frequency and consequences of medical errors in nephrology. We discuss practical applications of these in 3 settings: a computerized anemia-management program (CAMP, Henry Ford Health System, Detroit, MI), vascular access surveillance systems, and monthly capitation notes in the hemodialysis unit.

A CDMA system implementation with dimming control for visible light communication

NASA Astrophysics Data System (ADS)

Chen, Danyang; Wang, Jianping; Jin, Jianli; Lu, Huimin; Feng, Lifang

2018-04-01

Visible light communication (VLC), using solid-state lightings to transmit information, has become a complement technology to wireless radio communication. As a realistic multiple access scheme for VLC system, code division multiple access (CDMA) has attracted more and more attentions in recent years. In this paper, we address and implement an improved CDMA scheme for VLC system. The simulation results reveal that the improved CDMA scheme not only supports multi-users' transmission but also maintains dimming value at about 50% and enhances the system efficiency. It can also realize the flexible dimming control by adjusting some parameters of system structure, which rarely affects the system BER performance. A real-time experimental VLC system with improved CDMA scheme is performed based on field programmable gate array (FPGA), reaching a good BER performance.

Employing socially driven techniques for framing, contextualization, and collaboration in complex analytical threads

NASA Astrophysics Data System (ADS)

Wollocko, Arthur; Danczyk, Jennifer; Farry, Michael; Jenkins, Michael; Voshell, Martin

2015-05-01

The proliferation of sensor technologies continues to impact Intelligence Analysis (IA) work domains. Historical procurement focus on sensor platform development and acquisition has resulted in increasingly advanced collection systems; however, such systems often demonstrate classic data overload conditions by placing increased burdens on already overtaxed human operators and analysts. Support technologies and improved interfaces have begun to emerge to ease that burden, but these often focus on single modalities or sensor platforms rather than underlying operator and analyst support needs, resulting in systems that do not adequately leverage their natural human attentional competencies, unique skills, and training. One particular reason why emerging support tools often fail is due to the gap between military applications and their functions, and the functions and capabilities afforded by cutting edge technology employed daily by modern knowledge workers who are increasingly "digitally native." With the entry of Generation Y into these workplaces, "net generation" analysts, who are familiar with socially driven platforms that excel at giving users insight into large data sets while keeping cognitive burdens at a minimum, are creating opportunities for enhanced workflows. By using these ubiquitous platforms, net generation analysts have trained skills in discovering new information socially, tracking trends among affinity groups, and disseminating information. However, these functions are currently under-supported by existing tools. In this paper, we describe how socially driven techniques can be contextualized to frame complex analytical threads throughout the IA process. This paper focuses specifically on collaborative support technology development efforts for a team of operators and analysts. Our work focuses on under-supported functions in current working environments, and identifies opportunities to improve a team's ability to discover new information and disseminate insightful analytic findings. We describe our Cognitive Systems Engineering approach to developing a novel collaborative enterprise IA system that combines modern collaboration tools with familiar contemporary social technologies. Our current findings detail specific cognitive and collaborative work support functions that defined the design requirements for a prototype analyst collaborative support environment.

Computer-Based Medical System

NASA Technical Reports Server (NTRS)

1998-01-01

SYMED, Inc., developed a unique electronic medical records and information management system. The S2000 Medical Interactive Care System (MICS) incorporates both a comprehensive and interactive medical care support capability and an extensive array of digital medical reference materials in either text or high resolution graphic form. The system was designed, in cooperation with NASA, to improve the effectiveness and efficiency of physician practices. The S2000 is a MS (Microsoft) Windows based software product which combines electronic forms, medical documents, records management, and features a comprehensive medical information system for medical diagnostic support and treatment. SYMED, Inc. offers access to its medical systems to all companies seeking competitive advantages.

Current Research Activities in Drive System Technology in Support of the NASA Rotorcraft Program

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Zakrajsek, James J.

2006-01-01

Drive system technology is a key area for improving rotorcraft performance, noise/vibration reduction, and reducing operational and manufacturing costs. An overview of current research areas that support the NASA Rotorcraft Program will be provided. Work in drive system technology is mainly focused within three research areas: advanced components, thermal behavior/emergency lubrication system operation, and diagnostics/prognostics (also known as Health and Usage Monitoring Systems (HUMS)). Current research activities in each of these activities will be presented. Also, an overview of the conceptual drive system requirements and possible arrangements for the Heavy Lift Rotorcraft program will be reviewed.

Analytical and CASE study on Limited Search, ID3, CHAID, C4.5, Improved C4.5 and OVA Decision Tree Algorithms to design Decision Support System

NASA Astrophysics Data System (ADS)

Kaur, Parneet; Singh, Sukhwinder; Garg, Sushil; Harmanpreet

2010-11-01

In this paper we study about classification algorithms for farm DSS. By applying classification algorithms i.e. Limited search, ID3, CHAID, C4.5, Improved C4.5 and One VS all Decision Tree on common data set of crop with specified class, results are obtained. The tool used to derive results is SPINA. The graphical results obtained from tool are compared to suggest best technique to develop farm Decision Support System. This analysis would help to researchers to design effective and fast DSS for farmer to take decision for enhancing their yield.

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review.

PubMed

Matthews, John; Win, Khin Than; Oinas-Kukkonen, Harri; Freeman, Mark

2016-03-01

Persuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood.

Supporting the Loewenstein occupational therapy cognitive assessment using distributed user interfaces.

PubMed

Tesoriero, Ricardo; Gallud Lazaro, Jose A; Altalhi, Abdulrahman H

2017-02-01

Improve the quantity and quality of information obtained from traditional Loewenstein Occupational Therapy Cognitive Assessment Battery systems to monitor the evolution of patients' rehabilitation process as well as to compare different rehabilitation therapies. The system replaces traditional artefacts with virtual versions of them to take advantage of cutting edge interaction technology. The system is defined as a Distributed User Interface (DUI) supported by a display ecosystem, including mobile devices as well as multi-touch surfaces. Due to the heterogeneity of the devices involved in the system, the software technology is based on a client-server architecture using the Web as the software platform. The system provides therapists with information that is not available (or it is very difficult to gather) using traditional technologies (i.e. response time measurements, object tracking, information storage and retrieval facilities, etc.). The use of DUIs allows therapists to gather information that is unavailable using traditional assessment methods as well as adapt the system to patients' profile to increase the range of patients that are able to take this assessment. Implications for Rehabilitation Using a Distributed User Interface environment to carry out LOTCAs improves the quality of the information gathered during the rehabilitation assessment. This system captures physical data regarding patient's interaction during the assessment to improve the rehabilitation process analysis. Allows professionals to adapt the assessment procedure to create different versions according to patients' profile. Improves the availability of patients' profile information to therapists to adapt the assessment procedure.

Improved Real-Time Monitoring Using Multiple Expert Systems

NASA Technical Reports Server (NTRS)

Schwuttke, Ursula M.; Angelino, Robert; Quan, Alan G.; Veregge, John; Childs, Cynthia

1993-01-01

Monitor/Analyzer of Real-Time Voyager Engineering Link (MARVEL) computer program implements combination of techniques of both conventional automation and artificial intelligence to improve monitoring of complicated engineering system. Designed to support ground-based operations of Voyager spacecraft, also adapted to other systems. Enables more-accurate monitoring and analysis of telemetry, enhances productivity of monitoring personnel, reduces required number of such personnel by performing routine monitoring tasks, and helps ensure consistency in face of turnover of personnel. Programmed in C language and includes commercial expert-system software shell also written in C.

Defense Management: DOD Needs to Improve Program Management, Policy, and Testing to Enhance Ability to Field Operationally Useful Non-lethal Weapons

DTIC Science & Technology

2009-04-01

through Fielding and Support 12 Figure 3: Active Denial System 2 25 Figure 4: FN-303 Less-Lethal Launching System 26 Figure 5: TASER ® X-26 27 Figure 6...System Grenades 5, 6, 8, 9, 11, 12 , 13, 14, 19, 21, 25, 26 Human Electro Muscular Incapacitation TASER ® X-26 5, 13, 14, 21 Improved Acoustic...modes Modular accessory shotgun system Provides the capability to fire lethal, non-lethal, and door- breaching 12 - gauge rounds. Future force

The Effects of Computerized Information Systems on Juvenile Courts

ERIC Educational Resources Information Center

Albrecht, Gary L.

1976-01-01

Organizational theorists alternatively hypothesized that computerized information systems (CIS) will produce no necessary changes, centralization, or decentralization in juvenile courts. This hypothesis is supported by the results of a four year study on the phenomenon. Suggestions are offered for improving the juvenile judicial system through…

Software Requirements Specification of A Proposed Plant Property Management Information System for the Naval Postgraduate School.

DTIC Science & Technology

1982-12-01

information system (MIS) to support Plant Account equipment related functions could eliminate data handling redundancy and improved Plant Account...system users and accountability for more than 2000 individual equipment items worth over seven million dollars. Implementation of a management

Sensor Needs for Advanced Life Support

NASA Technical Reports Server (NTRS)

Graf, John C.

2000-01-01

Sensors and feedback systems are critical to life support flight systems and life support systems research. New sensor capabilities can allow for new system architectures to be considered, and can facilitate dramatic improvements in system performance. This paper will describe three opportunities for biosensor researchers to develop sensors that will enable life support system improvements. The first opportunity relates to measuring physical, chemical, and biological parameters in the Space Station Water Processing System. Measuring pH, iodine, total organic carbon, microbiological activity, total dissolved solids, or conductivity with a safe, effective, stable, reliable microsensor could benefit the water processing system considerably. Of special interest is a sensor which can monitor biological contamination rapidly. The second opportunity relates to sensing microbiological contamination and water condensation on the surface of large inflatable structures. It is the goal of large inflatable structures used for habitation to take advantage of the large surface area of the structure and reject waste heat passively through the walls of the structure. Too much heat rejection leads to a cold spot with water condensation, and eventually microbiological contamination. A distributed sensor system that can measure temperature, humidity, and microbiological contamination across a large surface would benefit designers of large inflatable habitable structures. The third opportunity relates to sensing microbial bioreactors used for waste water processing and reuse. Microbiological bioreactors offer considerable advantages in weight and power compared to adsorption bed based systems when used for long periods of time. Managing and controlling bioreactors is greatly helped if distributed microsensors measured the biological populations continuously in many locations within the bioreactor. Nitrifying bacteria are of special interest to bioreactor designers, and any sensors that could measure the populations of these types of bacteria would help the control and operation of bioreactors. J

Developing Reliable Life Support for Mars

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2017-01-01

A human mission to Mars will require highly reliable life support systems. Mars life support systems may recycle water and oxygen using systems similar to those on the International Space Station (ISS). However, achieving sufficient reliability is less difficult for ISS than it will be for Mars. If an ISS system has a serious failure, it is possible to provide spare parts, or directly supply water or oxygen, or if necessary bring the crew back to Earth. Life support for Mars must be designed, tested, and improved as needed to achieve high demonstrated reliability. A quantitative reliability goal should be established and used to guide development t. The designers should select reliable components and minimize interface and integration problems. In theory a system can achieve the component-limited reliability, but testing often reveal unexpected failures due to design mistakes or flawed components. Testing should extend long enough to detect any unexpected failure modes and to verify the expected reliability. Iterated redesign and retest may be required to achieve the reliability goal. If the reliability is less than required, it may be improved by providing spare components or redundant systems. The number of spares required to achieve a given reliability goal depends on the component failure rate. If the failure rate is under estimated, the number of spares will be insufficient and the system may fail. If the design is likely to have undiscovered design or component problems, it is advisable to use dissimilar redundancy, even though this multiplies the design and development cost. In the ideal case, a human tended closed system operational test should be conducted to gain confidence in operations, maintenance, and repair. The difficulty in achieving high reliability in unproven complex systems may require the use of simpler, more mature, intrinsically higher reliability systems. The limitations of budget, schedule, and technology may suggest accepting lower and less certain expected reliability. A plan to develop reliable life support is needed to achieve the best possible reliability.

Improving Quality for Child Care Centers in Greater Philadelphia: An Evaluation of Success by 6®. Technical Appendix. Publication #2016-07B

ERIC Educational Resources Information Center

Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin

2016-01-01

The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). The SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…

Improving Quality for Child Care Centers in Greater Philadelphia: An Evaluation of Success by 6®. Executive Summary. Publication #2016-07A

ERIC Educational Resources Information Center

Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin

2016-01-01

The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). The SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…

Improving Quality for Child Care Centers in Greater Philadelphia: An Evaluation of Success by 6®. Program Design Appendix. Publication #2016-07C

ERIC Educational Resources Information Center

Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin

2016-01-01

The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). The SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…

Improving Quality for Child Care Centers in Greater Philadelphia: An Evaluation of Success by 6®. Final Report. Publication #2016-07

ERIC Educational Resources Information Center

Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin

2016-01-01

The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). This SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…

Can mobile technology improve response times of junior doctors to urgent out-of-hours calls? A prospective observational study.

PubMed

Herrod, P J J; Barclay, C; Blakey, J D

2014-04-01

The Hospital at Night system has been widely adopted to manage Out-of-Hours workload. However, it has the potential to introduce delays and corruption of information. The introduction of newer technologies to replace landlines, pagers and paper may ameliorate these issues. To establish if the introduction of a Hospital at Night system supported by a wireless taskflow system affected the escalation of high Early Warning Scores (EWSs) to medical attention, and the time taken to medical review. Prospective 'pre and post' observational study in a teaching hospital in the UK. Review of observation charts and medical records, and data extraction from the electronic taskflow system. The implementation of a technology-supported Hospital at Night system was associated with a significant decrease in time to documentation of initial review in those who were reviewed. However, there was no change in the proportion of those with a high EWS that were reviewed, and throughout the study a majority of patients with high EWSs were not reviewed in accordance with guidelines. Introduction of a Hospital at Night system supported by mobile technology appeared to improve the transfer of information, but did not affect the nursing decision whether to escalate abnormal findings.

An architecture model for multiple disease management information systems.

PubMed

Chen, Lichin; Yu, Hui-Chu; Li, Hao-Chun; Wang, Yi-Van; Chen, Huang-Jen; Wang, I-Ching; Wang, Chiou-Shiang; Peng, Hui-Yu; Hsu, Yu-Ling; Chen, Chi-Huang; Chuang, Lee-Ming; Lee, Hung-Chang; Chung, Yufang; Lai, Feipei

2013-04-01

Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

The clinical nurse specialist: leadership in quality improvement.

PubMed

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

Improve wildlife species tracking—Implementing an enhanced global positioning system data management system for California condors

USGS Publications Warehouse

Waltermire, Robert G.; Emmerich, Christopher U.; Mendenhall, Laura C.; Bohrer, Gil; Weinzierl, Rolf P.; McGann, Andrew J.; Lineback, Pat K.; Kern, Tim J.; Douglas, David C.

2016-05-03

U.S. Fish and Wildlife Service (USFWS) staff in the Pacific Southwest Region and at the Hopper Mountain National Wildlife Refuge Complex requested technical assistance to improve their global positioning system (GPS) data acquisition, management, and archive in support of the California Condor Recovery Program. The USFWS deployed and maintained GPS units on individual Gymnogyps californianus (California condor) in support of long-term research and daily operational monitoring and management of California condors. The U.S. Geological Survey (USGS) obtained funding through the Science Support Program to provide coordination among project participants, provide GPS Global System for Mobile Communication (GSM) transmitters for testing, and compare GSM/GPS with existing Argos satellite GPS technology. The USFWS staff worked with private companies to design, develop, and fit condors with GSM/GPS transmitters. The Movebank organization, an online database of animal tracking data, coordinated with each of these companies to automatically stream their GPS data into Movebank servers and coordinated with USFWS to improve Movebank software for managing transmitter data, including proofing/error checking of incoming GPS data. The USGS arranged to pull raw GPS data from Movebank into the USGS California Condor Management and Analysis Portal (CCMAP) (https://my.usgs.gov/ccmap) for production and dissemination of a daily map of condor movements including various automated alerts. Further, the USGS developed an automatic archiving system for pulling raw and proofed Movebank data into USGS ScienceBase to comply with the Federal Information Security Management Act of 2002. This improved data management system requires minimal manual intervention resulting in more efficient data flow from GPS data capture to archive status. As a result of the project’s success, Pinnacles National Park and the Ventana Wildlife Society California condor programs became partners and adopted the same workflow, tracking, and data archive system. This GPS tracking data management model and workflow should be applicable and beneficial to other wildlife tracking programs.

Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership

PubMed Central

Kebede, Yenew; Fonjungo, Peter N.; Tibesso, Gudeta; Shrivastava, Ritu; Nkengasong, John N.; Kenyon, Thomas; Kebede, Amha; Gadde, Renuka; Ayana, Gonfa

2016-01-01

Background. Nonstandardized specimen-transport logistics, lack of laboratory personnel to transport specimens, lack of standard specimen containers, and long turnaround time (TAT) hindered access to quality laboratory services. The objective of the Becton, Dickinson, and Company (BD)–US President's Emergency Plan for AIDS Relief (PEPFAR) Public-Private Partnership (PPP) was to support country-specific programs to develop integrated laboratory systems, services, and quality improvement strategies, with an emphasis on strengthening the specimen-referral system (SRS). Methods. In 2007, through the Centers for Disease Control and Prevention (CDC), the Ethiopian Public Health Institute (EPHI) joined with the BD-PEPFAR PPP to strengthen laboratory systems. A joint planning and assessment committee identified gaps in the SRS for prioritization and intervention and piloted the system in Addis Ababa and Amhara Region. Results. The PPP established standardized, streamlined specimen logistics, using the Ethiopian Postal Service Enterprise to support a laboratory network in which 554 facilities referred specimens to 160 laboratories. The PPP supported procuring 400 standard specimen containers and the training of 586 laboratory personnel and 81 postal workers. The average TAT was reduced from 7 days (range, 2–14 days) to 2 days (range, 1–3 days) in Addis Ababa and from 10 days (range, 6–21 days) to 5 days (range, 2–6 days) in Amhara Region. Conclusions. This study highlights the feasibility and untapped potential of PPPs to strengthen laboratory systems. This planned and structured approach to improving specimen referral enhanced access to quality laboratory services. PMID:27025700

Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs

PubMed Central

2013-01-01

Background Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. Description of approaches We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Conclusions Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health. PMID:23819662

Traffic management centers : the state-of-the-practice : task A : final working paper for design of support systems for advanced traffic management systems

DOT National Transportation Integrated Search

1999-02-01

The goal of the Federal Highway Administration (FHWA) Expert Systems for Crash Data Collection Program was to use expert system technology to improve the accuracy and consistency of police-reported data. The program included the development and evalu...

Systems 2020: Strategic Initiative

DTIC Science & Technology

2010-08-29

research areas that enable agile, assured, efficient, and scalable systems engineering approaches to support the development of these systems. This...To increase development efficiency and ensure flexible solutions in the field, systems engineers need powerful, agile, interoperable, and scalable...design and development will be transformed as a result of Systems 2020, along with complementary enabling acquisition practice improvements initiated in

DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study.

PubMed

Wang, Shan; Zhu, Xiaohe; Zhao, Xian; Lu, Yang; Yang, Zhifu; Qian, Xiaoliang; Li, Weiwei; Ma, Lixiazi; Guo, Huning; Wang, Jingwen; Wen, Aidong

2016-03-01

The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types (p < 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % (p < 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level.

Better Off with or without Your CMS? 5 Kinds of Assessment That Can Really Help.

ERIC Educational Resources Information Center

Ehrmann, Stephen C.; Gilbert, Steven W.

2003-01-01

Presents five areas to consider to help establish the value and improve the effectiveness of a course management system (CMS). Highlights include faculty use to improve teaching effectiveness; changes in support strategies to improve the value of a CMS; increasing enrollment or retention; controlling costs; and identifying barriers to desired…

The Memory Support System for Mild Cognitive Impairment: Randomized trial of a cognitive rehabilitation intervention

PubMed Central

Greenaway, M. C.; Duncan, N. L.; Smith, G. E.

2013-01-01

Objective Individuals with amnestic Mild Cognitive Impairment (MCI) have few empirically-based treatment options for combating their memory loss. This study sought to examine the efficacy of a calendar/notebook rehabilitation intervention, the Memory Support System (MSS), for individuals with amnestic MCI. Methods Forty individuals with single domain amnestic MCI and their program partners were randomized to receive the MSS, either with training or without (controls). Measures of adherence, activities of daily living, and emotional impact were completed at the first and last intervention session and again at 8-weeks and 6 months post intervention. Results Training in use of a notebook/calendar system significantly improved adherence over those who received the calendars but no training. Functional ability and memory self efficacy significantly improved for those who received MSS training. Change in functional ability remained significantly better in the intervention group than in the control group out to 8 week follow up. Care partners in the intervention group demonstrated improved mood by 8 week and 6 month follow-up, while control care partners reported worse caregiver burden by 6 month follow up. Conclusions MSS training resulted in improvement in ADLs and sense of memory self efficacy for individuals with MCI. While ADL benefits were maintained out to 8 weeks post intervention, future inclusion of booster sessions may help extend the therapeutic effect out even further. Improved mood of care partners of trained individuals and worsening sense of caregiver burden over time for partners of untrained individuals further supports the efficacy of the MSS for MCI. PMID:22678947

Identification of design features to enhance utilization and acceptance of systems for Internet-based decision support at the point of care.

PubMed

Gadd, C S; Baskaran, P; Lobach, D F

1998-01-01

Extensive utilization of point-of-care decision support systems will be largely dependent on the development of user interaction capabilities that make them effective clinical tools in patient care settings. This research identified critical design features of point-of-care decision support systems that are preferred by physicians, through a multi-method formative evaluation of an evolving prototype of an Internet-based clinical decision support system. Clinicians used four versions of the system--each highlighting a different functionality. Surveys and qualitative evaluation methodologies assessed clinicians' perceptions regarding system usability and usefulness. Our analyses identified features that improve perceived usability, such as telegraphic representations of guideline-related information, facile navigation, and a forgiving, flexible interface. Users also preferred features that enhance usefulness and motivate use, such as an encounter documentation tool and the availability of physician instruction and patient education materials. In addition to identifying design features that are relevant to efforts to develop clinical systems for point-of-care decision support, this study demonstrates the value of combining quantitative and qualitative methods of formative evaluation with an iterative system development strategy to implement new information technology in complex clinical settings.

Design and Development of a Sharable Clinical Decision Support System Based on a Semantic Web Service Framework.

PubMed

Zhang, Yi-Fan; Gou, Ling; Tian, Yu; Li, Tian-Chang; Zhang, Mao; Li, Jing-Song

2016-05-01

Clinical decision support (CDS) systems provide clinicians and other health care stakeholders with patient-specific assessments or recommendations to aid in the clinical decision-making process. Despite their demonstrated potential for improving health care quality, the widespread availability of CDS systems has been limited mainly by the difficulty and cost of sharing CDS knowledge among heterogeneous healthcare information systems. The purpose of this study was to design and develop a sharable clinical decision support (S-CDS) system that meets this challenge. The fundamental knowledge base consists of independent and reusable knowledge modules (KMs) to meet core CDS needs, wherein each KM is semantically well defined based on the standard information model, terminologies, and representation formalisms. A semantic web service framework was developed to identify, access, and leverage these KMs across diverse CDS applications and care settings. The S-CDS system has been validated in two distinct client CDS applications. Model-level evaluation results confirmed coherent knowledge representation. Application-level evaluation results reached an overall accuracy of 98.66 % and a completeness of 96.98 %. The evaluation results demonstrated the technical feasibility and application prospect of our approach. Compared with other CDS engineering efforts, our approach facilitates system development and implementation and improves system maintainability, scalability and efficiency, which contribute to the widespread adoption of effective CDS within the healthcare domain.

Comparison of Overridden Medication-related Clinical Decision Support in the Intensive Care Unit between a Commercial System and a Legacy System.

PubMed

Wong, Adrian; Wright, Adam; Seger, Diane L; Amato, Mary G; Fiskio, Julie M; Bates, David

2017-08-23

Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement. To compare the two systems and identify areas for potential improvement with the new commercial system at a single institution. Overridden medication-related CDS alerts were included from October to December of the systems' respective years (legacy, 2011; commercial, 2015), restricted to three intensive care units. The two systems were compared with regards to CDS presentation and override rates for four types of CDS: drug-allergy, drug-drug interaction (DDI), geriatric and renal alerts. A post hoc analysis to evaluate for adverse drug events (ADEs) potentially resulting from overridden alerts was performed for 'contraindicated' DDIs via chart review. There was a significant increase in provider exposure to alerts and alert overrides in the commercial system (commercial: n=5,535; legacy: n=1,030). Rates of overrides were higher for the allergy and DDI alerts (p<0.001) in the commercial system. Geriatric and renal alerts were significantly different in incidence and presentation between the two systems. No ADEs were identified in an analysis of 43 overridden contraindicated DDI alerts. The vendor system had much higher rates of both alerts and overrides, although we did not find evidence of harm in a review of DDIs which were overridden. We propose recommendations for improving our current system which may be helpful to other similar institutions; improving both alert presentation and the underlying knowledge base appear important.

Trajectory-Based Takeoff Time Predictions Applied to Tactical Departure Scheduling: Concept Description, System Design, and Initial Observations

NASA Technical Reports Server (NTRS)

Engelland, Shawn A.; Capps, Alan

2011-01-01

Current aircraft departure release times are based on manual estimates of aircraft takeoff times. Uncertainty in takeoff time estimates may result in missed opportunities to merge into constrained en route streams and lead to lost throughput. However, technology exists to improve takeoff time estimates by using the aircraft surface trajectory predictions that enable air traffic control tower (ATCT) decision support tools. NASA s Precision Departure Release Capability (PDRC) is designed to use automated surface trajectory-based takeoff time estimates to improve en route tactical departure scheduling. This is accomplished by integrating an ATCT decision support tool with an en route tactical departure scheduling decision support tool. The PDRC concept and prototype software have been developed, and an initial test was completed at air traffic control facilities in Dallas/Fort Worth. This paper describes the PDRC operational concept, system design, and initial observations.

Integrated Data & Analysis in Support of Informed and Transparent Decision Making

NASA Astrophysics Data System (ADS)

Guivetchi, K.

2012-12-01

The California Water Plan includes a framework for improving water reliability, environmental stewardship, and economic stability through two initiatives - integrated regional water management to make better use of local water sources by integrating multiple aspects of managing water and related resources; and maintaining and improving statewide water management systems. The Water Plan promotes ways to develop a common approach for data standards and for understanding, evaluating, and improving regional and statewide water management systems, and for common ways to evaluate and select from alternative management strategies and projects. The California Water Plan acknowledges that planning for the future is uncertain and that change will continue to occur. It is not possible to know for certain how population growth, land use decisions, water demand patterns, environmental conditions, the climate, and many other factors that affect water use and supply may change by 2050. To anticipate change, our approach to water management and planning for the future needs to consider and quantify uncertainty, risk, and sustainability. There is a critical need for information sharing and information management to support over-arching and long-term water policy decisions that cross-cut multiple programs across many organizations and provide a common and transparent understanding of water problems and solutions. Achieving integrated water management with multiple benefits requires a transparent description of dynamic linkages between water supply, flood management, water quality, land use, environmental water, and many other factors. Water Plan Update 2013 will include an analytical roadmap for improving data, analytical tools, and decision-support to advance integrated water management at statewide and regional scales. It will include recommendations for linking collaborative processes with technical enhancements, providing effective analytical tools, and improving and sharing data and information. Specifically, this includes achieving better integration and consistency with other planning activities; obtaining consensus on quantitative deliverables; building a common conceptual understanding of the water management system; developing common schematics of the water management system; establishing modeling protocols and standards; and improving transparency and exchange of Water Plan information.

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

PubMed

Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives

PubMed Central

Chelico, John D.; Wilcox, Adam B.; Vawdrey, David K.; Kuperman, Gilad J.

2016-01-01

Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement. PMID:28269833

Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

PubMed

Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

2011-06-01

Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

Smart infrared inspection system field operational test : [technology brief].

DOT National Transportation Integrated Search

2014-04-01

One of the main goals of the Commercial Vehicle : Roadside Technology Corridor (CMVRTC) is to : support and evaluate the use of innovative : technologies that improve commercial truck and bus : safety. The Smart Infrared Inspection System : (SIRIS) w...

Rail Transit System Maintenance Practices for Automatic Fare Collection Equipment

DOT National Transportation Integrated Search

1984-05-01

A review of rail transit system maintenance practices for automatic fare collection (AFC) equipment was performed. This study supports an UMTA sponsored program to improve the reliability of AFC equipment. The maintenance practices of the transit sys...

An improved NAS-RIF algorithm for image restoration

NASA Astrophysics Data System (ADS)

Gao, Weizhe; Zou, Jianhua; Xu, Rong; Liu, Changhai; Li, Hengnian

2016-10-01

Space optical images are inevitably degraded by atmospheric turbulence, error of the optical system and motion. In order to get the true image, a novel nonnegativity and support constants recursive inverse filtering (NAS-RIF) algorithm is proposed to restore the degraded image. Firstly the image noise is weaken by Contourlet denoising algorithm. Secondly, the reliable object support region estimation is used to accelerate the algorithm convergence. We introduce the optimal threshold segmentation technology to improve the object support region. Finally, an object construction limit and the logarithm function are added to enhance algorithm stability. Experimental results demonstrate that, the proposed algorithm can increase the PSNR, and improve the quality of the restored images. The convergence speed of the proposed algorithm is faster than that of the original NAS-RIF algorithm.

Supporting and Inhibiting Factors When Coping with Endometriosis From the Patientsʼ Perspective

PubMed Central

Kundu, S.; Wildgrube, J.; Schippert, C.; Hillemanns, P.; Brandes, I.

2015-01-01

Aim: Endometriosis is a chronic gynaecological disorder with manifold symptoms and psychosocial effects on the lives of affected women. The prevalence of endometriosis is estimated to be up to ten percent of women of reproductive age. As a result of its unclear aetiology, only limited treatment options are available. The treatment and care of affected women is therefore a challenge for their doctors. There is a need for healthcare services to provide affected women with support to cope with the disorder better. The aim of the study was to identify supporting and inhibiting factors on disease management to develop new support ideas. Materials and Methods: The results are based on a content analysis evaluation of text responses from 135 women with confirmed endometriosis. Open questions about disease management were posed in a patient questionnaire. A classification system was developed according to Mayrings Qualitative Content Analysis, which allowed the main topics to be identified and summarised qualitatively using a quantitative intermediate step. Results: Social support, treatment, as well as professional and healthcare system performance were found to be particularly supportive by patients. However, when questioned about inhibiting factors, healthcare system professionals and their performance were most commonly criticised. Just over 50 % of women expressed their criticism of doctors. Quality of care and empathy towards the patients were especially criticised. There is also a need for improvement with regard to communication and general support from doctors. The results illustrate the importance of doctors for women affected by endometriosis, but make it clear that there is a great need for improvement with regard to the profession. Conclusion: The results provide the first indication of problem areas in the management of endometriosis from which approaches could be developed to improve care. However, it must be pointed out that the perspective of affected women was solely investigated. For a comprehensive analysis, it would be necessary to include the perspective of care providers and the influence of society as well as the healthcare system. PMID:26097250

Implementation and results of an integrated data quality assurance protocol in a randomized controlled trial in Uttar Pradesh, India.

PubMed

Gass, Jonathon D; Misra, Anamika; Yadav, Mahendra Nath Singh; Sana, Fatima; Singh, Chetna; Mankar, Anup; Neal, Brandon J; Fisher-Bowman, Jennifer; Maisonneuve, Jenny; Delaney, Megan Marx; Kumar, Krishan; Singh, Vinay Pratap; Sharma, Narender; Gawande, Atul; Semrau, Katherine; Hirschhorn, Lisa R

2017-09-07

There are few published standards or methodological guidelines for integrating Data Quality Assurance (DQA) protocols into large-scale health systems research trials, especially in resource-limited settings. The BetterBirth Trial is a matched-pair, cluster-randomized controlled trial (RCT) of the BetterBirth Program, which seeks to improve quality of facility-based deliveries and reduce 7-day maternal and neonatal mortality and maternal morbidity in Uttar Pradesh, India. In the trial, over 6300 deliveries were observed and over 153,000 mother-baby pairs across 120 study sites were followed to assess health outcomes. We designed and implemented a robust and integrated DQA system to sustain high-quality data throughout the trial. We designed the Data Quality Monitoring and Improvement System (DQMIS) to reinforce six dimensions of data quality: accuracy, reliability, timeliness, completeness, precision, and integrity. The DQMIS was comprised of five functional components: 1) a monitoring and evaluation team to support the system; 2) a DQA protocol, including data collection audits and targets, rapid data feedback, and supportive supervision; 3) training; 4) standard operating procedures for data collection; and 5) an electronic data collection and reporting system. Routine audits by supervisors included double data entry, simultaneous delivery observations, and review of recorded calls to patients. Data feedback reports identified errors automatically, facilitating supportive supervision through a continuous quality improvement model. The five functional components of the DQMIS successfully reinforced data reliability, timeliness, completeness, precision, and integrity. The DQMIS also resulted in 98.33% accuracy across all data collection activities in the trial. All data collection activities demonstrated improvement in accuracy throughout implementation. Data collectors demonstrated a statistically significant (p = 0.0004) increase in accuracy throughout consecutive audits. The DQMIS was successful, despite an increase from 20 to 130 data collectors. In the absence of widely disseminated data quality methods and standards for large RCT interventions in limited-resource settings, we developed an integrated DQA system, combining auditing, rapid data feedback, and supportive supervision, which ensured high-quality data and could serve as a model for future health systems research trials. Future efforts should focus on standardization of DQA processes for health systems research. ClinicalTrials.gov identifier, NCT02148952 . Registered on 13 February 2014.

Designing an Intervention for Women with Systemic Lupus Erythematosus from Medically Underserved Areas to Improve Care: A Qualitative Study

PubMed Central

Feldman, Candace H; Bermas, Bonnie L; Zibit, Melanie; Fraser, Patricia; Todd, Derrick J; Fortin, Paul R; Massarotti, Elena; Costenbader, Karen H

2013-01-01

Objective Systemic lupus erythematosus (lupus) disproportionately affects women, racial/ethnic minorities and low-income populations. We held focus groups for women from medically underserved communities to discuss interventions to improve care. Methods From our Lupus Registry, we invited 282 women, > 18 years, residing in urban, medically underserved areas. Hospital-based clinics and support groups also recruited participants. Women were randomly assigned to 3 focus groups. 75-minute sessions were recorded, transcribed and coded thematically using interpretative phenomenologic analysis and single counting methods. We categorized interventions by benefits, limitations, target populations and implementation questions. Results 29 women with lupus participated in 3 focus groups, (n=9, 9, 11). 80% were African American and 83% were from medically underserved zip codes. Themes included the desire for lupus education, isolation at the time of diagnosis, emotional and physical barriers to care, and the need for assistance navigating the healthcare system. 20 of 29 participants (69%) favored a peer support intervention; 17 (59%) also supported a lupus health passport. Newly diagnosed women were optimal intervention targets. Improvements in quality of life and mental health were proposed outcome measures. Conclusion Women with lupus from medically underserved areas have unique needs best addressed with an intervention designed through collaboration between community members and researchers. PMID:23087258

Referral criteria and clinical decision support: radiological protection aspects for justification.

PubMed

Pérez, M del Rosario

2015-06-01

Advanced imaging technology has opened new horizons for medical diagnostics and improved patient care. However, many procedures are unjustified and do not provide a net benefit. An area of particular concern is the unnecessary use of radiation when clinical evaluation or other imaging modalities could provide an accurate diagnosis. Referral criteria for medical imaging are consensus statements based on the best-available evidence to assist the decision-making process when choosing the best imaging procedure for a given patient. Although they are advisory rather than compulsory, physicians should have good reasons for deviation from these criteria. Voluntary use of referral criteria has shown limited success compared with integration into clinical decision support systems. These systems support good medical practice, can improve health service delivery, and foster safer, more efficient, fair, cost-effective care, thus contributing to the strengthening of health systems. Justification of procedures and optimisation of protection, the two pillars of radiological protection in health care, are implicit in the notion of good medical practice. However, some health professionals are not familiar with these principles, and have low awareness of radiological protection aspects of justification. A stronger collaboration between radiation protection and healthcare communities could contribute to improve the radiation protection culture in medical practice. © The Chartered Institution of Building Services Engineers 2014.

The Selective Use of Radiation Therapy in Rectal Cancer Patients.

PubMed

Martella, Andrew; Willett, Christopher; Palta, Manisha; Czito, Brian

2018-04-11

Colorectal cancer has a high global incidence, and standard treatment employs a multimodality approach. In addition to cure, minimizing treatment-related toxicity and improving the therapeutic ratio is a common goal. The following article addresses the potential of omitting radiotherapy in select rectal cancer patients. Omission of radiotherapy in rectal cancer is analyzed in the context of historical findings, as well as more recent data describing risk stratification of stage II-III disease, surgical optimization, imaging limitations, improvement in systemic chemotherapeutic agents, and contemporary studies evaluating selective omission of radiotherapy. A subset of rectal cancer patients exists that may be considered low to intermediate risk for locoregional recurrence. With appropriate staging, surgical technique, and possibly improved systemic therapy, it may be feasible to selectively omit radiotherapy in these patients. Current imaging limitations as well as evidence of increased locoregional recurrence following radiotherapy omission lend us to continue supporting the standard treatment of approach of neoadjuvant chemoradiation therapy followed by surgical resection until additional improvements and prospective evidence can support otherwise.

Marine Tactical Command and Control System (MTACCS) Field Development System-1 (FDS-1) assessment: Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Avery, L.W.; Hunt, S.T.; Savage, S.F.

1992-04-01

The United State Marine Corps (USMC) is continuing the development and fielding of the Marine Corps Tactical Command and Control System (MTACCS), a system which exists in varying states of development, fielding, or modernization. MTACCS is currently composed of the following components: Tactical Combat Operations System (TCO) for ground command and control (C2), Intelligence Analysis System (IAS) with a Genser terminal connected to a TCO workstation for intelligence C2, Marine Integrated Personnel System (MIPS) and a TCO workstation using the Marine Combat Personnel System (MCPERS) software for personnel C2, Marine Integrated Logistics System (MILOGS) which is composed of the Landingmore » Force Asset Distribution System (LFADS), the Marine Air-Ground Task Force (MAGTF) II, and a TCO terminal using the Marine Combat Logistics System (MCLOG) for logistics C2, Marine Corps Fire Support System (MCFSS) for fire support C2, and Advanced Tactical Air Command Central (ATACC) and the Improved Direct Air Support Central for aviation C2.« less

Advanced Boost System Developing for High EGR Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sun, Harold

2012-09-30

To support industry efforts of clean and efficient internal combustion engine development for passenger and commercial applications • This program focuses on turbocharger improvement for medium and light duty diesel applications, from complete system optimization percepective to enable commercialization of advanced diesel combustion technologies, such as HCCI/LTC. • Improve combined turbocharger efficiency up to 10% or fuel economy by 3% on FTP cycle at Tier II Bin 5 emission level.

Advances in Engine Test Capabilities at the NASA Glenn Research Center's Propulsion Systems Laboratory

NASA Technical Reports Server (NTRS)

Pachlhofer, Peter M.; Panek, Joseph W.; Dicki, Dennis J.; Piendl, Barry R.; Lizanich, Paul J.; Klann, Gary A.

2006-01-01

The Propulsion Systems Laboratory at the National Aeronautics and Space Administration (NASA) Glenn Research Center is one of the premier U.S. facilities for research on advanced aeropropulsion systems. The facility can simulate a wide range of altitude and Mach number conditions while supplying the aeropropulsion system with all the support services necessary to operate at those conditions. Test data are recorded on a combination of steady-state and highspeed data-acquisition systems. Recently a number of upgrades were made to the facility to meet demanding new requirements for the latest aeropropulsion concepts and to improve operational efficiency. Improvements were made to data-acquisition systems, facility and engine-control systems, test-condition simulation systems, video capture and display capabilities, and personnel training procedures. This paper discusses the facility s capabilities, recent upgrades, and planned future improvements.

Development of the bedridden person support system using hand gesture.

PubMed

Ichimura, Kouhei; Magatani, Kazushige

2015-08-01

The purpose of this study is to support the bedridden and physically handicapped person who live independently. In this study, we developed Electric appliances control system that can be used on the bed. The subject can control Electric appliances using hand motion. Infrared sensors of a Kinect are used for the hand motion detection. Our developed system was tested with some normal subjects and results of the experiment were evaluated. In this experiment, all subjects laid on the bed and tried to control our system. As results, most of subjects were able to control our developed system perfectly. However, motion tracking of some subject's hand was reset forcibly. It was difficult for these subjects to make the system recognize his opened hand. From these results, we think if this problem will be improved our support system will be useful for the bedridden and physically handicapped persons.

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

PubMed

Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

2018-05-15

The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

A multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention in nursing homes: a two-armed randomized controlled trial.

PubMed

Beeckman, Dimitri; Clays, Els; Van Hecke, Ann; Vanderwee, Katrien; Schoonhoven, Lisette; Verhaeghe, Sofie

2013-04-01

Frail older people admitted to nursing homes are at risk of a range of adverse outcomes, including pressure ulcers. Clinical decision support systems are believed to have the potential to improve care and to change the behaviour of healthcare professionals. To determine whether a multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention improves adherence to recommendations for pressure ulcer prevention in nursing homes. Two-armed randomized controlled trial in a nursing home setting in Belgium. The trial consisted of a 16-week implementation intervention between February and June 2010, including one baseline, four intermediate, and one post-testing measurement. Primary outcome was the adherence to guideline-based care recommendations (in terms of allocating adequate pressure ulcer prevention in residents at risk). Secondary outcomes were the change in resident outcomes (pressure ulcer prevalence) and intermediate outcomes (knowledge and attitudes of healthcare professionals). Random sample of 11 wards (6 experimental; 5 control) in a convenience sample of 4 nursing homes in Belgium. In total, 464 nursing home residents and 118 healthcare professionals participated. The experimental arm was involved in a multi-faceted tailored implementation intervention of a clinical decision support system, including interactive education, reminders, monitoring, feedback and leadership. The control arm received a hard-copy of the pressure ulcer prevention protocol, supported by standardized 30 min group lecture. Patients in the intervention arm were significantly more likely to receive fully adequate pressure ulcer prevention when seated in a chair (F=16.4, P=0.003). No significant improvement was observed on pressure ulcer prevalence and knowledge of the professionals. While baseline attitude scores were comparable between both groups [exp. 74.3% vs. contr. 74.5% (P=0.92)], the mean score after the intervention was 83.5% in the experimental group vs. 72.1% in the control group (F=15.12, P<0.001). The intervention was only partially successful to improve the primary outcome. Attitudes improved significantly while the knowledge of the healthcare workers remained unsatisfactorily low. Further research should focus on the underlying reasons for these findings. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Safer Delivery of Surgical Services Program (S3): Explaining Its Differential Effectiveness and Exploring Implications for Improving Quality in Complex Systems.

PubMed

Flynn, Lorna C; McCulloch, Peter G; Morgan, Lauren J; Robertson, Eleanor R; New, Steve J; Stedman, Francesca E; Martin, Graham P

2016-12-01

To analyze the challenges encountered during surgical quality improvement interventions, and explain the relative success of different intervention strategies. Understanding why and how interventions work is vital for developing improvement science. The S3 Program of studies tested whether combining interventions addressing culture and system was more likely to result in improvement than either approach alone. Quantitative results supported this theory. This qualitative study investigates why this happened, what aspects of the interventions and their implementation most affected improvement, and the implications for similar programs. Semistructured interviews were conducted with hospital staff (23) and research team members (11) involved in S3 studies. Analysis was based on the constant comparative method, with coding conducted concurrently with data collection. Themes were identified and developed in relation to the program theory behind S3. The superior performance of combined intervention over single intervention arms appeared related to greater awareness and ability to act, supporting the S3 hypothesis. However, we also noted unforeseen differences in implementation that seemed to amplify this difference. The greater ambition and more sophisticated approach in combined intervention arms resulted in requests for more intensive expert support, which seemed crucial in their success. The contextual challenges encountered have potential implications for the replicability and sustainability of the approach. Our findings support the S3 hypothesis, triangulating with quantitative results and providing an explanatory account of the causal relationship between interventions and outcomes. They also highlight the importance of implementation strategies, and of factors outside the control of program designers.

Modular survivable satellite support

NASA Astrophysics Data System (ADS)

Wagner, R. E.

The development of a highly mobile, survivable satellite system from the Transportable Mobile Ground Station (T/MGS) is proposed. The addition of advanced capabilities to the T/MGS such as telemetry processing equipment, and the flexibility of a modularly designed system are examined. The need to increase survivability and mobility while reducing life cycle costs is discussed. A modular survivable satellite support system which consists of a 40-foot van, a diesel tractor, and a multimedia communications subsystem is described. The use of planar and phased arrays to improve transportability and new materials and structural designs to enhance hardness are discussed. Diagrams of the system are provided.

Strengthening Indian Country through Tribal Youth Programs

ERIC Educational Resources Information Center

Pearson, Sarah S.

2009-01-01

Grants awarded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) Tribal Youth Program (TYP) support and enhance tribal efforts to prevent and control delinquency and improve the juvenile justice system for American Indian/Alaska Native (AI/AN) youth ages 17 and under. TYPs operate in tribal communities, supporting tribal efforts…

Make Kids Count: Giving Babies a Smart Beginning.

ERIC Educational Resources Information Center

Thompson, Anne, Ed.

The Smart Beginnings project in Arizona is designed to increase public awareness and parent education about early childhood development and family support resources. The program is intended to identify, link, establish, and expand a public/private family support system and improve the quality and increase availability of infant and toddler child…

32 CFR 32.21 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... For awards that support research, it should be noted that it is generally not appropriate to develop... that support research. (5) Written procedures to minimize the time elapsing between the transfer of... Cash Management Improvement Act (CMIA) (Pub. L. 101-453) govern, payment methods of State agencies...

Navigating Rough Waters: Hawaiian Science Teachers Discuss Identity

ERIC Educational Resources Information Center

Allaire, Franklin S.

2013-01-01

Research with Native Hawaiian science teachers is contributing to a better understanding of issues relating to equity in science education, and toward improving science curriculum to support Native Hawaiian students as well as support systems for Native Hawaiian students interested in pursuing higher education and science-based careers.…

Evaluating Federal Support for Poverty Research.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC.

Federal support for research on poverty is discussed, and principal funding agencies are identified. The value of research on poverty for policy making is discussed and evaluated, with particular attention to the work of the Institute for Research on Poverty. The report recommends that the system for funding the Institute be improved, that…

Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

PubMed

Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

2016-10-01

To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and establishing a motivated and skilled project or program team. The lack of evaluative data made it difficult to identify the most effective interventions or models of care. The CanIMPACT Casebook documents Canadian efforts to improve or support the coordination of cancer care by PCPs and oncology specialists as a means to improve patient outcomes and cancer system performance. Copyright© the College of Family Physicians of Canada.

Future directions in flight simulation: A user perspective

NASA Technical Reports Server (NTRS)

Jackson, Bruce

1993-01-01

Langley Research Center was an early leader in simulation technology, including a special emphasis in space vehicle simulations such as the rendezvous and docking simulator for the Gemini program and the lunar landing simulator used before Apollo. In more recent times, Langley operated the first synergistic six degree of freedom motion platform (the Visual Motion Simulator, or VMS) and developed the first dual-dome air combat simulator, the Differential Maneuvering Simulator (DMS). Each Langley simulator was developed more or less independently from one another with different programming support. At present time, the various simulation cockpits, while supported by the same host computer system, run dissimilar software. The majority of recent investments in Langley's simulation facilities have been hardware procurements: host processors, visual systems, and most recently, an improved motion system. Investments in software improvements, however, have not been of the same order.

Updating strategies for isolating and discovering giant viruses.

PubMed

Khalil, Jacques Yaacoub Bou; Andreani, Julien; La Scola, Bernard

2016-06-01

Almost fifteen years ago, the discovery of Acanthamoeba polyphaga mimivirus, the first giant virus, changed how we define a virus. It was discovered incidentally in a process of isolating Legionella sp. from environmental samples in the context of pneumonia epidemics using a co-culture system with Acanthamoeba. Since then, much effort and improvement has been put into the original technique. In addition to the known families of Mimiviridae and Marseilleviridae, four new proposed families of giant viruses have been isolated: Pandoravirus, Pithovirus, Faustovirus and Mollivirus. Major improvements were based on enrichment systems, targeted use of antibiotics and high-throughput methods. The most recent development, using flow cytometry for isolation and presumptive identification systems, opens a path to large environmental surveys that may discover new giant virus families in new protozoa supports used for culture support. Copyright © 2016 Elsevier Ltd. All rights reserved.

Identifying Opportunities for Decision Support Systems in Support of Regional Resource Use Planning: An Approach Through Soft Systems Methodology.

PubMed

Zhu; Dale

2000-10-01

/ Regional resource use planning relies on key regional stakeholder groups using and having equitable access to appropriate social, economic, and environmental information and assessment tools. Decision support systems (DSS) can improve stakeholder access to such information and analysis tools. Regional resource use planning, however, is a complex process involving multiple issues, multiple assessment criteria, multiple stakeholders, and multiple values. There is a need for an approach to DSS development that can assist in understanding and modeling complex problem situations in regional resource use so that areas where DSSs could provide effective support can be identified, and the user requirements can be well established. This paper presents an approach based on the soft systems methodology for identifying DSS opportunities for regional resource use planning, taking the Central Highlands Region of Queensland, Australia, as a case study.

Airspace Systems Program: Next Generation Air Transportation System, NextGen Systems Analysis, Integration and Evaluation Project. Version 1.0; Project Plan

NASA Technical Reports Server (NTRS)

Quon, Leighton

2010-01-01

The key objectives of the NASA ASP are to: Improve mobility, capacity efficiency and access of the airspace system. Improve collaboration, predictability, and flexibility for the airspace users. Enable accurate modeling and simulation of air transportation systems. Accommodate operations of all classes of aircraft. Maintain system safety and environmental protection. In support of these program objectives, the major goal of the NextGen-SAIE Project is to enable the transition of key capacity and efficiency improvements to the NAS. Since many aspects of the NAS are unique to specific airport or airspace environments, demand on various parts of the NAS is not expected to increase equally as system demand grows. SAIE will provide systems level analysis of the NAS characteristics, constraints, and demands such that a suite of capacity-increasing concepts and technologies for system solutions are enabled and facilitated. The technical objectives in support of this goal are the following: Integration, evaluation, and transition of more mature concepts and technologies in an environment that faithfully emulates real-world complexities. Interoperability research and analysis of ASP technologies across ATM functions is performed to facilitate integration and take ASP concepts and technologies to higher Technology Readiness Level (TRL). Analyses are conducted on the program s concepts to identify the system benefits or impacts. System level analysis is conducted to increase understanding of the characteristics and constraints of airspace system and its domains.

Enhancing Critical Thinking Via a Clinical Scholar Approach.

PubMed

Simpson, Vicki; McComb, Sara A; Kirkpatrick, Jane M

2017-11-01

Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.]. Copyright 2017, SLACK Incorporated.

The Development of an Interaction Support System for International Distance Education

ERIC Educational Resources Information Center

Yueh, Hsiu-Ping; Lin, Weijane; Liu, Yi-Lin; Shoji, Tetsuo; Minoh, Michihiko

2014-01-01

This paper reports on the implementation of a learner identification system developed to facilitate real-time interaction in an international distance course. To increase the teacher immediacy and social presence, it proposes an integrative system for incorporating technology to improve the learning involvement, teaching effectiveness, and quality…

Improving Information Products for System 2 Decision Support

ERIC Educational Resources Information Center

Gibson, Neal

2010-01-01

The creation, maintenance, and management of Information Product (IP) systems that are used by organizations for complex decisions represent a unique set of challenges. These challenges are compounded when the purpose of such a systems is also for knowledge creation and dissemination. Information quality research to date has focused mainly upon…

A Manual Transactional System for the IR Office.

ERIC Educational Resources Information Center

Black, Frank S.

The development and operation of a transactional system (defined as a routine method for carrying out certain processes) without computer support at Texas Southern University's Office of Institutional Research is described. The system was developed in 1975 primarily to improve the internal management of the office. It is a standard operating…

Significant acceleration of emergency response using smartphone geolocation data and a worldwide emergency call support system.

PubMed

Weinlich, Michael; Kurz, Peter; Blau, Melissa B; Walcher, Felix; Piatek, Stefan

2018-01-01

When patients are disorientated or experience language barriers, it is impossible to activate the emergency response system. In these cases, the delay for receiving appropriate help can extend to several hours. A worldwide emergency call support system (ECSS), including geolocation of modern smartphones (GPS, WLAN and LBS), was established referring to E911 and eCall systems. The system was tested for relevance in quickly forwarding abroad emergency calls to emergency medical services (EMS). To verify that geolocation data from smartphones are exact enough to be used for emergency cases, the accuracy of GPS (global positioning system), Wi-Fi (wireless LAN network) and LBS (location based system) was tested in eleven different countries and compared to actual location. The main objective was analyzed by simulation of emergencies in different countries. The time delay in receiving help in unsuccessful emergency call cases by using the worldwide emergency call support system (ECSS) was measured. GPS is the gold standard to locate patients with an average accuracy of 2.0 ± 3.3 m. Wi-Fi can be used within buildings with an accuracy of 7.0 ± 24.1 m. Using ECSS, the emergency call leads to a successful activation of EMS in 22.8 ± 10.8 min (Median 21 min). The use of a simple app with one button to touch did never cause any delay. The worldwide emergency call support system (ECSS) significantly improves the emergency response in cases of disorientated patients or language barriers. Under circumstances without ECSS, help can be delayed by 2 or more hours and might have relevant lifesaving effects. This is the first time that Wi-Fi geolocation could prove to be a useful improvement in emergencies to enhance GPS, especially within or close to buildings.

Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

NASA Astrophysics Data System (ADS)

Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

2013-03-01

With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.